| Doctor Name: | LYNN A FONTANA |
| NPI Number: | 1003071721 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.F.T, PH.D. |
| License Number: | T0209 |
| Business Practice Address: | 8035 Ne Prescott St Portland, OR - 972184249 |
| Business Phone Number: | 5032237719 |
| Business Fax Number: | 5032554714 |
| Mailing Address: | 8035 Ne Prescott St, PORTLAND |
| State: | OR |
| Postal Code: | 972184249 |
| Phone Number: | 5032237719 |
| Fax Number: | 5032554714 |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 07/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | T0209 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |