Provider Demographics
NPI:1649306952
Name:DUNN, MEREDITH JOANNE (MA, LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:JOANNE
Last Name:DUNN
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MILBURN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-1654
Mailing Address - Country:US
Mailing Address - Phone:503-636-3371
Mailing Address - Fax:
Practice Address - Street 1:15110 SW BOONES FERRY RD
Practice Address - Street 2:SUITE 240
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3468
Practice Address - Country:US
Practice Address - Phone:503-545-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2129101YP2500X
CA38836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38836OtherBBS
ORC2129OtherOBLPCT