Provider Demographics
NPI:1669724522
Name:PALMER-DUDLEY, ERIN (LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PALMER-DUDLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:SUITE367
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-742-5300
Mailing Address - Fax:503-742-5979
Practice Address - Street 1:11211 SE 82ND AVE
Practice Address - Street 2:SUITE O
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7624
Practice Address - Country:US
Practice Address - Phone:503-722-6200
Practice Address - Fax:503-722-6545
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60245694101YM0800X
ORC3133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health