Provider Demographics
NPI:1295017721
Name:ROBINSON, RICK MCDONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:MCDONALD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 831
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-0137
Mailing Address - Country:US
Mailing Address - Phone:503-880-4804
Mailing Address - Fax:
Practice Address - Street 1:1285 HIDE A WAY LN
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-1646
Practice Address - Country:US
Practice Address - Phone:503-880-4804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR552103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling