Provider Demographics
NPI:1548528250
Name:SUTTON HIRSCH, CHRISTINA ALEXIS (PSYD, PSY)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ALEXIS
Last Name:SUTTON HIRSCH
Suffix:
Gender:F
Credentials:PSYD, PSY
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ALEXIS
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSY
Mailing Address - Street 1:10690 NE CORNELL RD STE 315
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9224
Mailing Address - Country:US
Mailing Address - Phone:503-352-0468
Mailing Address - Fax:
Practice Address - Street 1:10690 NE CORNELL RD STE 315
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9224
Practice Address - Country:US
Practice Address - Phone:503-352-0468
Practice Address - Fax:503-352-1024
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004583103TC0700X
OR3032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical