Provider Demographics
NPI:1750565503
Name:GUYTON DOAN, SANDRA GAIL (PSYD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:GAIL
Last Name:GUYTON DOAN
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 1:948 NW FOREST ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-2831
Mailing Address - Country:US
Mailing Address - Phone:503-544-3505
Mailing Address - Fax:
Practice Address - Street 1:2311 NW NORTHRUP ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2994
Practice Address - Country:US
Practice Address - Phone:503-544-3505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1819103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical