Provider Demographics
NPI:1699037739
Name:FOSTER, DAWN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19071 INDIAN SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8321
Mailing Address - Country:US
Mailing Address - Phone:503-970-6757
Mailing Address - Fax:
Practice Address - Street 1:13200 SW PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-4828
Practice Address - Country:US
Practice Address - Phone:503-970-6757
Practice Address - Fax:503-620-5899
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health