Provider Demographics
NPI:1982911657
Name:ERB, ANDREA L (PSYD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:ERB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10029 SW NIMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7110
Mailing Address - Country:US
Mailing Address - Phone:503-207-1160
Mailing Address - Fax:888-975-5734
Practice Address - Street 1:10029 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7110
Practice Address - Country:US
Practice Address - Phone:503-207-1160
Practice Address - Fax:888-975-5734
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2592103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical