Provider Demographics
NPI:1285791400
Name:BARRAM, R. ANDREW (PSYD)
Entity type:Individual
Prefix:DR
First Name:R.
Middle Name:ANDREW
Last Name:BARRAM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NW PARK PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2954
Mailing Address - Country:US
Mailing Address - Phone:541-388-3592
Mailing Address - Fax:
Practice Address - Street 1:25 NW PARK PL
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2954
Practice Address - Country:US
Practice Address - Phone:541-388-3592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1463103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist