Healthcare Provider Details

I. General information

NPI: 1538088562
Provider Name (Legal Business Name): GREGORY ALLEN BARRETT MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10175 SW BARBUR BLVD STE 210B
PORTLAND OR
97219-5901
US

IV. Provider business mailing address

10175 SW BARBUR BLVD STE 210B
PORTLAND OR
97219-5901
US

V. Phone/Fax

Practice location:
  • Phone: 971-917-6919
  • Fax:
Mailing address:
  • Phone: 971-917-6919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR8605
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: