Provider Demographics
NPI:1316953276
Name:KIRKLAND, JANET LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:LYNN
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2079 NW TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8938
Mailing Address - Country:US
Mailing Address - Phone:503-810-3269
Mailing Address - Fax:
Practice Address - Street 1:2079 NW TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8938
Practice Address - Country:US
Practice Address - Phone:503-810-3269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1250103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical