Provider Demographics
NPI:1558143818
Name:DAVID, TAUNYA D (CRGM, CRM, PWS)
Entity Type:Individual
Prefix:
First Name:TAUNYA
Middle Name:D
Last Name:DAVID
Suffix:
Gender:F
Credentials:CRGM, CRM, PWS
Other - Prefix:
Other - First Name:TAUNYA
Other - Middle Name:D
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TAUNYA GOLDEN
Mailing Address - Street 1:10209 SE DIVISION ST # C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1372
Mailing Address - Country:US
Mailing Address - Phone:971-420-9139
Mailing Address - Fax:
Practice Address - Street 1:10209 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1372
Practice Address - Country:US
Practice Address - Phone:971-420-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)