Provider Demographics
NPI:1568518140
Name:HOUSTON, BARBARA M (PSYD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:HOUSTON
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 1:1880 WILLAMETTE FALLS DR STE 230
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4654
Mailing Address - Country:US
Mailing Address - Phone:503-657-4300
Mailing Address - Fax:
Practice Address - Street 1:1880 WILLAMETTE FALLS DR STE 230
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4654
Practice Address - Country:US
Practice Address - Phone:503-657-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1355103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR104388Medicare ID - Type Unspecified