IRENE LIEBAN (NPI# 1538321526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538321526 |
| Entity Type | Individual |
| Full Name | IRENE LIEBAN |
| Credential | PSY.D |
| Practice Address |
2801 N Gantenbein Ave Pediatric Development & Rehab Portland OR 97227-1623 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5034134506 |
| Practice Fax Number | 5034134379 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034134158 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
791 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 068601 | 05 |
| Street Address |
2801 N GANTENBEIN AVE PEDIATRIC DEVELOPMENT & REHAB |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027198 | James P Mccord | Pediatrics | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2005-07-20 |
| 1225639040 | Lina Rossetti-grulich | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-11-06 |
| 1033722673 | Karen Bronson | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-08-24 |
| 1356969331 | Sandy Hammer | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-07-07 |
| 1225673999 | Odaisa Igwe | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-16 |
| 1952945578 | Julie Lorine Hoover | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-06 |
| 1285278648 | Kate Harrell Unterberger | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-29 |
| 1780227082 | Keegan Carly Fritzke | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-21 |
| 1578106860 | Corinne Frohlick | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-20 |
| 1386287662 | Aimee Breitfelder Reddy | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740616325 | Kathleen Gregorich Hoffman | Psychologist | 3245 Nw Thurman St, Portland, OR 97210-1224 | 2013-09-16 |
| 1558708461 | Anthony Michael Duncan | Psychologist | 2236 Se Belmont St, Portland, OR 97214-2817 | 2013-05-31 |
| 1083998611 | Kaufman Psychological Services | Psychologist | 1321 Washington Ave Ste 102, Portland, ME 04103-3636 | 2011-09-30 |
| 1174813539 | Robert W Mclellarn, Phd | Psychologist | 5440 Sw Westgate Drive, Suite 175, Portland, OR 97221 | 2011-04-19 |
| 1346574449 | Jerusha Beth Detweiler-bedell | Psychologist | 5440 Sw Westgate Dr., #175, Portland, OR 97221-2436 | 2009-09-23 |
| 1386845048 | Morris Tiktin | Psychologist | 1201 Sw 12 Ave, Suite 300, Portland, OR 97205-2046 | 2007-05-30 |
| 1235341629 | Muriel D. Lezak | Psychologist | 2211 Sw 1st Ave, G10, Portland, OR 97201-5060 | 2007-05-05 |
| 1952528952 | Melisa L. Finch | Psychologist | 10201 Se Main St Ste 10, Portland, OR 97216-2937 | 2007-04-19 |
| 1992712103 | Maryann J Carroll | Psychologist | 25 Bedell St, Portland, ME 04103-1705 | 2006-08-01 |
| 1588642953 | Joseph Peter Gretsch | Psychologist | 818 Sw 3rd Ave, #148, Portland, OR 97204-2405 | 2006-01-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.