Most Relevant Information
Provider Data
| NPI Number: | 1003564063 |
| Provider Name: | COLLIN HYDE |
| Entity Type: | Individual |
| Taxonomy Code: | 167G00000X |
| Specialty: | Licensed Psychiatric Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/17/2022 |
| Last Updated: | 03/17/2022 |
Provider Practice Location
7511 N BERKELEY AVE APT 7
PORTLAND
OR
972036095
Practice Location Phone/Fax
| Phone: | 2816781275 |
| Fax: |
Provider Mailing Location
7511 N BERKELEY AVE APT 7
PORTLAND
OR
972036095
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |