Provider Demographics
NPI:1891128906
Name:LLOYD, KARIN S (PHD)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:S
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:L
Other - Last Name:SANDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3101 SE 192ND AVE STE 103
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1443
Practice Address - Country:US
Practice Address - Phone:360-666-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2667103T00000X
WAPY60926217103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist