Provider Demographics
NPI:1629200274
Name:HARMAN, ANGELA LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LYNN
Last Name:HARMAN
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 1:1219 SE LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3802
Mailing Address - Country:US
Mailing Address - Phone:503-765-5733
Mailing Address - Fax:
Practice Address - Street 1:1219 SE LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3802
Practice Address - Country:US
Practice Address - Phone:503-765-5733
Practice Address - Fax:971-244-8583
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-16
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1924103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist