Provider Demographics
NPI:1851627517
Name:BETHUNE, ANN STRACHAN (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:STRACHAN
Last Name:BETHUNE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 SW KELLY AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4389
Mailing Address - Country:US
Mailing Address - Phone:503-297-3999
Mailing Address - Fax:
Practice Address - Street 1:4004 SW KELLY AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4389
Practice Address - Country:US
Practice Address - Phone:503-297-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional