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Search › Oregon › 101YP2500X

Ethan Pettyjohn, LPC

NPI 1619452307 · on the registry since 2018

Practice

Address
9755 Sw Barnes Rd
Portland, OR 97225
Phone
(503) 444-4862
Organisation at this address
Sports Psychiatry Center Llc
Nw Spine Management Rehabilitation And Sports Conditioning, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
18

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Licence states on file
OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-11-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon