Individual
PAULA LYNN FOTHERGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CADCII
Contact information
Practice address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Mailing address
1631 SW COLUMBIA ST, TATE TOPO / ANNEX, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
04-03-43U
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126370
—
OR
Enumeration date
01/30/2006
Last updated
01/06/2016
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