Provider Demographics
NPI:1003104100
Name:SAMLAN, HILLEL (PHD)
Entity type:Individual
Prefix:DR
First Name:HILLEL
Middle Name:
Last Name:SAMLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 NW YEON AVE UNIT 274
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-1519
Mailing Address - Country:US
Mailing Address - Phone:503-278-5908
Mailing Address - Fax:
Practice Address - Street 1:917 SW OAK ST STE 417
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2807
Practice Address - Country:US
Practice Address - Phone:503-278-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2025-05-28
Deactivation Date:2020-10-08
Deactivation Code:
Reactivation Date:2020-10-14
Provider Licenses
StateLicense IDTaxonomies
OR3583103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling