Provider Demographics
NPI:1821231770
Name:REYBURN, ERIN RW (LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RW
Last Name:REYBURN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6647 SE MILWAUKIE AVE STE B210
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5661
Mailing Address - Country:US
Mailing Address - Phone:206-714-5610
Mailing Address - Fax:
Practice Address - Street 1:8507 S 115TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-3928
Practice Address - Country:US
Practice Address - Phone:206-794-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7444101YM0800X
WALH60018016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health