Provider Demographics
NPI:1598722316
Name:DUKE, LCSW, PAUL II (PAUL DUKE, LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:DUKE, LCSW
Suffix:II
Gender:M
Credentials:PAUL DUKE, LCSW
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:DUKE, LCSW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PAUL DUKE, LCSW
Mailing Address - Street 1:2590 12TH PL SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-2536
Mailing Address - Country:US
Mailing Address - Phone:503-363-0626
Mailing Address - Fax:503-585-5529
Practice Address - Street 1:2590 12TH PL SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2536
Practice Address - Country:US
Practice Address - Phone:503-363-0626
Practice Address - Fax:503-585-5529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR003421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical