Provider Demographics
NPI:1730306259
Name:DAINES, JOSEPH W (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:W
Last Name:DAINES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12720 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2703
Mailing Address - Country:US
Mailing Address - Phone:503-620-1191
Mailing Address - Fax:
Practice Address - Street 1:12720 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2703
Practice Address - Country:US
Practice Address - Phone:503-620-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0700106H00000X
WA60540107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist