Provider Demographics
NPI:1902042781
Name:MCKIBBIN, KAREN JULIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JULIE
Last Name:MCKIBBIN
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Gender:F
Credentials:PSYD
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Mailing Address - Street 1:10300 SW GREENBURG ROAD, SUITE 240
Mailing Address - Street 2:PORTLAND AUTISM CENTER, LLC
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5410
Mailing Address - Country:US
Mailing Address - Phone:503-593-3331
Mailing Address - Fax:503-206-7596
Practice Address - Street 1:10300 SW GREENBURG RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5410
Practice Address - Country:US
Practice Address - Phone:503-593-3331
Practice Address - Fax:503-206-7596
Is Sole Proprietor?:No
Enumeration Date:2008-12-27
Last Update Date:2013-11-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent