Provider Demographics
NPI:1972741205
Name:DUNCAN, ALEXANDER CHARLES (PSYD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:CHARLES
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PSYD, ABPP
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:CHARLES
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD, ABPP
Mailing Address - Street 1:PO BOX 82287
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0287
Mailing Address - Country:US
Mailing Address - Phone:503-807-7180
Mailing Address - Fax:503-236-2700
Practice Address - Street 1:6124 SE MILWAUKIE AVE STE C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5347
Practice Address - Country:US
Practice Address - Phone:503-807-7180
Practice Address - Fax:503-236-2700
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1912103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist