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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

Other

Enumeration date
08/18/2025
Last updated
08/18/2025
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