Provider Demographics
NPI:1255116547
Name:DANFORD, ABIGAIL TUVEL (MA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:TUVEL
Last Name:DANFORD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:LEVITT
Other - Last Name:TUVEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 SE 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2569
Mailing Address - Country:US
Mailing Address - Phone:503-622-8964
Mailing Address - Fax:
Practice Address - Street 1:905 SE 14TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2569
Practice Address - Country:US
Practice Address - Phone:503-622-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORR9837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program