Guastadisegni, Paul Edward
Guastadisegni, Paul Edward is an sole proprietor health care provider with primary practice located at 511 Sw 10Th Ave Suite 1115, Portland OR 97205-2732. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Guastadisegni, Paul Edward can be contacted via phone (503) 223-7766.Contact Information
Primary practice address
511 Sw 10Th Ave Suite 1115
Portland OR 97205-2732
Phone: (503) 223-7766
Fax: (503) 223-8844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 1307 | Oregon |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1307 | Oregon |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 1307 | Oregon |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 1307 | Oregon |
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | 1307 | Oregon |
Profile Details
| NPI number | 1356460901 |
|---|---|
| LBN Legal business name | Guastadisegni, Paul Edward |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356460901 | NPPES |
| Oregon | Other | M39331 | OREGON VENDOR NUMBER |
| Oregon | MEDICAID | 159027 | OREGON VENDOR NUMBER |
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