Provider Demographics
NPI:1346366200
Name:ROBB, HAROLD BUCHANAN III (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:BUCHANAN
Last Name:ROBB
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:HANK
Other - Middle Name:
Other - Last Name:ROBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:19801 S HAZELHURST LN
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-9233
Mailing Address - Country:US
Mailing Address - Phone:503-523-8562
Mailing Address - Fax:
Practice Address - Street 1:19801 S HAZELHURST LN
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-9233
Practice Address - Country:US
Practice Address - Phone:503-523-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR699103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR930934599OtherFEDERAL TAXPAYER ID