Healthcare Provider Details

I. General information

NPI: 1235132499
Provider Name (Legal Business Name): CLAUDIA BYRNE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW BETHANY BLVD STE 200
BEAVERTON OR
97006-5236
US

IV. Provider business mailing address

3525 NW SUNSET VIEW TER
PORTLAND OR
97229-8320
US

V. Phone/Fax

Practice location:
  • Phone: 512-709-8311
  • Fax: 844-329-7820
Mailing address:
  • Phone: 512-709-8311
  • Fax: 844-329-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number31887
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2895
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: