Provider Demographics
NPI:1629322177
Name:DURFLINGER, VIVIANA MARIE (ATR-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:VIVIANA
Middle Name:MARIE
Last Name:DURFLINGER
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11425 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4080
Mailing Address - Country:US
Mailing Address - Phone:407-314-1305
Mailing Address - Fax:
Practice Address - Street 1:3220 NW 185TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-3492
Practice Address - Country:US
Practice Address - Phone:407-314-1305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001594-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health