Provider Demographics
NPI:1043463839
Name:POST-HOLMBERG, JEFFREY BEHRENS (MA)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BEHRENS
Last Name:POST-HOLMBERG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:JEFFREY
Other - Middle Name:BEHRENS
Other - Last Name:POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2080 NW EVERETT ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1011
Mailing Address - Country:US
Mailing Address - Phone:971-282-1350
Mailing Address - Fax:
Practice Address - Street 1:2080 NW EVERETT ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1011
Practice Address - Country:US
Practice Address - Phone:971-282-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR1796, R1775106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist