Individual
MRS. CHANTELLE K DOCKTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
5700 SW DOSCH RD, PORTLAND, OR 97239-1153
(503) 636-4176
Mailing address
PO BOX 214, TUALATIN, OR 97062-0214
(503) 636-4176
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C1678
OR
Other
Enumeration date
03/25/2007
Last updated
07/08/2007
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