Provider Demographics
NPI:1609353622
Name:RAMIREZ, ALYSSA M (PHD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:M
Other - Last Name:RAMIREZ STEGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3050 SE DIVISION ST STE 215
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1997
Mailing Address - Country:US
Mailing Address - Phone:503-622-8964
Mailing Address - Fax:
Practice Address - Street 1:3050 SE DIVISION ST STE 215
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1997
Practice Address - Country:US
Practice Address - Phone:503-622-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3768103T00000X
WI4096-57103T00000X
WA61071463103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)