Provider Demographics
NPI:1932253127
Name:BYRNE, ROBERT NEAL (MS MFCC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:NEAL
Last Name:BYRNE
Suffix:
Gender:M
Credentials:MS MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12726
Mailing Address - Street 2:1818 NE IRVING
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2726
Mailing Address - Country:US
Mailing Address - Phone:503-232-5565
Mailing Address - Fax:503-239-7990
Practice Address - Street 1:1818 NE IRVING
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232
Practice Address - Country:US
Practice Address - Phone:503-232-5565
Practice Address - Fax:503-239-7990
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist