Provider Demographics
NPI:1184857062
Name:ATIKUNE, CARRIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:ATIKUNE
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 1:2153 SW MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205
Mailing Address - Country:US
Mailing Address - Phone:971-888-0497
Mailing Address - Fax:971-404-2468
Practice Address - Street 1:2153 SW MAIN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205
Practice Address - Country:US
Practice Address - Phone:971-888-0497
Practice Address - Fax:971-404-2468
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health