Provider Demographics
NPI:1770540742
Name:GOFF, BRIAN CRAIG (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CRAIG
Last Name:GOFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1110 SE ALDER STREET
Mailing Address - Street 2:STE 301 - PMB 144
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2400
Mailing Address - Country:US
Mailing Address - Phone:503-224-0482
Mailing Address - Fax:503-462-1413
Practice Address - Street 1:5901 S MACADAM AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3620
Practice Address - Country:US
Practice Address - Phone:503-224-0482
Practice Address - Fax:503-462-1413
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR1704103TB0200X
OR1407103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral