Provider Demographics
NPI:1336446814
Name:CULLEN, ROBYN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:CULLEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 SE 25TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2075
Mailing Address - Country:US
Mailing Address - Phone:619-208-5221
Mailing Address - Fax:
Practice Address - Street 1:1235 SE DIVISION ST STE 203B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1087
Practice Address - Country:US
Practice Address - Phone:949-779-0953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53820106H00000X
ORT2461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist