Healthcare Provider Details

I. General information

NPI: 1669531992
Provider Name (Legal Business Name): STEPHEN ALLAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE ALLANKETNER PH.D.

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 MISTLETOE LOOP N
KEIZER OR
97303-4307
US

IV. Provider business mailing address

958 MISTLETOE LOOP N
KEIZER OR
97303-4307
US

V. Phone/Fax

Practice location:
  • Phone: 541-517-4674
  • Fax:
Mailing address:
  • Phone: 541-517-4674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1171
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: