Provider Demographics
NPI:1225287162
Name:POLLAK, DOROTHY M (DOTTIE POLLAK, MA)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:M
Last Name:POLLAK
Suffix:
Gender:F
Credentials:DOTTIE POLLAK, MA
Other - Prefix:
Other - First Name:DOTTIE
Other - Middle Name:
Other - Last Name:POLLAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOTTIE POLLAK
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0113
Mailing Address - Country:US
Mailing Address - Phone:541-548-6166
Mailing Address - Fax:541-548-6168
Practice Address - Street 1:1379 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2905
Practice Address - Country:US
Practice Address - Phone:541-548-6166
Practice Address - Fax:541-548-6168
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health