Provider Demographics
NPI:1710229752
Name:FOSTER, LUANN KRISTINE (PSYD)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:KRISTINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 E PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-4009
Mailing Address - Country:US
Mailing Address - Phone:971-268-0807
Mailing Address - Fax:
Practice Address - Street 1:200 N RIVER ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2716
Practice Address - Country:US
Practice Address - Phone:971-268-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2561103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist