Provider Demographics
NPI:1568733467
Name:HOOGEN, SIRI R (PHD)
Entity Type:Individual
Prefix:DR
First Name:SIRI
Middle Name:R
Last Name:HOOGEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 NE 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3420
Mailing Address - Country:US
Mailing Address - Phone:503-421-1597
Mailing Address - Fax:
Practice Address - Street 1:975 SE SANDY BLVD STE 160
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2498
Practice Address - Country:US
Practice Address - Phone:971-201-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21836103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical