Healthcare Provider Details

I. General information

NPI: 1134360282
Provider Name (Legal Business Name): ALLEN LYNN HALL JR. MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12636 SE STARK ST BLDG J
PORTLAND OR
97233-1058
US

IV. Provider business mailing address

12636 SE STARK ST BLDG J
PORTLAND OR
97233-1058
US

V. Phone/Fax

Practice location:
  • Phone: 503-253-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC5742
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: