Doctor Name: | DR. DOUGLAS L DUNLAP |
NPI Number: | 1003055278 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 769 |
Business Practice Address: | 1121 Ne 2nd Ave Portland, OR - 972322043 |
Business Phone Number: | 5037318692 |
Business Fax Number: | |
Mailing Address: | 1121 Ne 2nd Ave, PORTLAND |
State: | OR |
Postal Code: | 972322043 |
Phone Number: | 5037318692 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2009 |
NPI Last Update Date: | 02/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |