Individual
LAURA FAYE DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CADC1
Contact information
Practice address
1122 NE 122ND AVE STE A102, PORTLAND, OR 97230-2082
(503) 901-4203
Mailing address
18501 E BURNSIDE ST, PORTLAND, OR 97233-5316
(503) 901-4203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-11-04
OR
163W00000X
Registered Nurse
200341401RN
OR
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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