Provider Demographics
NPI:1356125603
Name:TRULLINGER-DWYER, CAITLYN FAY (MA)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:FAY
Last Name:TRULLINGER-DWYER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 SW BARBUR BLVD STE 380
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5430
Mailing Address - Country:US
Mailing Address - Phone:503-758-2879
Mailing Address - Fax:
Practice Address - Street 1:9320 SW BARBUR BLVD STE 380
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5430
Practice Address - Country:US
Practice Address - Phone:503-758-2879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health