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General NPI Number Information
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NPI Number | 1457897142
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Entity Type | Individual
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Provider Name | HEATHER L ALLEN PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2870 NE WEST DEVILS LAKE RD
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City | LINCOLN CITY
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State | OR
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Zip | 97367-5127
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Country | US
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Telephone | 541-994-9191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1189
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City | CORVALLIS
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State | OR
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Zip | 97339-1189
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY61161855
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3894
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY61161855
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License Number State | WA
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