Provider Demographics
NPI:1164610663
Name:MORAN, ERIN COOK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:COOK
Last Name:MORAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SW GREENBURG RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5410
Mailing Address - Country:US
Mailing Address - Phone:503-860-2592
Mailing Address - Fax:503-206-7596
Practice Address - Street 1:10300 SW GREENBURG RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5410
Practice Address - Country:US
Practice Address - Phone:503-860-2592
Practice Address - Fax:503-206-7596
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist