Individual
HAYLEY DAUTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 NE 11TH AVE, PORTLAND, OR 97232
(503) 542-7635
(503) 296-2262
Mailing address
32 NE 11TH AVE, PORTLAND, OR 97232-3001
(503) 542-7635
(503) 296-2262
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3103
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
08/22/2013
Last updated
10/01/2019
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