Healthcare Provider Details

I. General information

NPI: 1114354305
Provider Name (Legal Business Name): CAITLIN ALLAWAY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 SE ALDER ST STE 301
PORTLAND OR
97214-2400
US

IV. Provider business mailing address

2728 DURANT AVE
BERKELEY CA
94704-1725
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-9230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3890
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: