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Organization
PORTLAND TRAUMA AND DISSOCIATION SPECIALISTS LLC
Active
Organization
PORTLAND TRAUMA AND DISSOCIATION SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER LYNN LAFONTAINE LCSW (CO-OWNER/PROVIDER)
(971) 895-1751
Entity
Organization
Contact information
Practice address
1831 SE 7TH AVE, PORTLAND, OR 97214-3578
(971) 895-1751
Mailing address
PO BOX 14701, PORTLAND, OR 97293-0701
(971) 895-1751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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