Provider Demographics
NPI:1770617425
Name:DEIHL, JOHN P (MSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:DEIHL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SW GRIFFITH DR
Mailing Address - Street 2:SUITE 239
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-5607
Mailing Address - Country:US
Mailing Address - Phone:503-520-9977
Mailing Address - Fax:
Practice Address - Street 1:4900 SW GRIFFITH DR
Practice Address - Street 2:SUITE 239
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-5607
Practice Address - Country:US
Practice Address - Phone:503-520-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7201041C0700X
ORT0064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist