Lieban, Irene

Lieban, Irene is an individual health care provider with primary practice located at 2801 N Gantenbein Ave Pediatric Development & Rehab, Portland OR 97227-1623. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Lieban, Irene can be contacted via phone (503) 413-4506.

Contact Information

Primary practice address
2801 N Gantenbein Ave Pediatric Development & Rehab Portland OR 97227-1623
Phone: (503) 413-4506
Fax: (503) 413-4379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 791 Oregon

Profile Details

NPI number 1538321526
LBN Legal business name Lieban, Irene
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2008
Last updated Jun 30th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538321526 NPPES
Oregon MEDICAID 068601

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