Provider Demographics
NPI:1558553164
Name:IRVINE, CHRISTINA HAMME (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:HAMME
Last Name:IRVINE
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 1:2015 NE 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-5215
Mailing Address - Country:US
Mailing Address - Phone:503-975-1729
Mailing Address - Fax:
Practice Address - Street 1:2105 NE CESAR E CHAVEZ BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-5438
Practice Address - Country:US
Practice Address - Phone:503-715-0910
Practice Address - Fax:503-715-0911
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid