DR. Charles Richard O'bannon, PH.D.

NPI #1508856642 in Gresham, Oregon

Provider Information

NPI Number: 1508856642
Entity Type: Individual
Name: DR. Charles Richard O'bannon, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: PH.D.
Enumeration Date: Oct 27, 2005
Last Updated: Oct 25, 2010

Practice Location

Address: 123 E POWELL BLVD
Address 2: STE. 212
City: Gresham
State: Oregon
ZIP Code: 97030-7622
Phone: (503) 618-8041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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