Provider Demographics
NPI:1831500107
Name:WEBB, KURT C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:C
Last Name:WEBB
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SW GILSON STREET
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6913
Mailing Address - Country:US
Mailing Address - Phone:503-931-7260
Mailing Address - Fax:888-975-3408
Practice Address - Street 1:717 SW GILSON STREET
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6913
Practice Address - Country:US
Practice Address - Phone:503-931-7260
Practice Address - Fax:888-975-3408
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical