Provider Demographics
NPI:1801142625
Name:CURTIS, WENDY HALL (LPC)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:HALL
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 SW VERMONT ST
Mailing Address - Street 2:SUITE P
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1945
Mailing Address - Country:US
Mailing Address - Phone:971-266-0631
Mailing Address - Fax:
Practice Address - Street 1:1820 SW VERMONT ST
Practice Address - Street 2:SUITE P
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1945
Practice Address - Country:US
Practice Address - Phone:971-266-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health