Provider Demographics
NPI:1013321967
Name:LOWE, DAVID J (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:LOWE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 NE CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-4210
Mailing Address - Country:US
Mailing Address - Phone:503-492-1200
Mailing Address - Fax:
Practice Address - Street 1:1890 NE CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-4210
Practice Address - Country:US
Practice Address - Phone:503-492-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional