Individual
IRENE LIEBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
2801 N GANTENBEIN AVE, PEDIATRIC DEVELOPMENT & REHAB, PORTLAND, OR 97227-1623
(503) 413-4506
(503) 413-4379
Mailing address
PO BOX 4037, PORTLAND, OR 97208-4037
(503) 413-4048
(503) 413-4158
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
791
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068601
—
OR
Enumeration date
06/30/2008
Last updated
04/12/2026
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