Provider Demographics
NPI:1669531992
Name:ALLAN, STEPHEN (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ALLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:ALLANKETNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1255 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3570
Mailing Address - Country:US
Mailing Address - Phone:541-687-6983
Mailing Address - Fax:541-687-2063
Practice Address - Street 1:1255 PEARL ST STE 102
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3570
Practice Address - Country:US
Practice Address - Phone:541-687-6983
Practice Address - Fax:541-687-2063
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1171103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical