Provider Demographics
NPI:1891805867
Name:CALKINS, PATRICIA ALICE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ALICE
Last Name:CALKINS
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 1:11630 SE 40TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6195
Mailing Address - Country:US
Mailing Address - Phone:503-653-2267
Mailing Address - Fax:503-652-4075
Practice Address - Street 1:11630 SE 40TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6195
Practice Address - Country:US
Practice Address - Phone:503-653-2267
Practice Address - Fax:503-652-4075
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1282103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist