MEDICARE: BARBARA M HOUSTON PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1355	OR

General Provider Information

NPI Number	:	1568518140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA M HOUSTON PSYD

Provider Business Mailing Address
First Line	:	1880 WILLAMETTE FALLS DR STE 230
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-4654
Country	:	US
Telephone Number	:	503-657-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 WILLAMETTE FALLS DR STE 230
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-4654
Country	:	US
Telephone Number	:	503-657-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	03/08/2012

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