Individual
DR. BENJAMIN DUNAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3001 N GANTENBEIN AVE, PORTLAND, OR 97227-1530
(303) 570-5190
Mailing address
3001 N GANTENBEIN AVE, PORTLAND, OR 97227-1530
(303) 570-5190
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2333
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021708
KAISER COMMERCIAL NUMBER
CO
05
—
66959772
—
CO
Enumeration date
08/12/2008
Last updated
01/31/2014
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