Healthcare Provider Details

I. General information

NPI: 1669123048
Provider Name (Legal Business Name): WEST OAK PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 NE 3RD ST
MCMINNVILLE OR
97128-4901
US

IV. Provider business mailing address

400 GLEN CREEK RD NW #5624
SALEM OR
97304-3060
US

V. Phone/Fax

Practice location:
  • Phone: 503-714-1237
  • Fax:
Mailing address:
  • Phone: 503-714-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MARTIN ROBISON
Title or Position: OWNER
Credential: PSYD
Phone: 503-714-1237