Provider Information for 1730470071
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COLLEEN MACKINTOSH ATR LPC
Other Names:Other Name:COLLEEN DUNCAN ATR LPCSex: Female
NPI: 1730470071
Last Updated: 2021-02-27
Certification Date: 2021-02-27
Certification Date: 2021-02-27
Details
| Name | Value | ||||||||||||
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| NPI | 1730470071 | ||||||||||||
| Enumeration Date | 2011-04-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 8490 SW NESTUCCA CT TUALATIN, OR 97062-9108 United States Phone: 971-207-2538 | Fax: | ||||||||||||
| Primary Practice Address | 1904 SE DIVISION ST PORTLAND, OR 97202-1146 United States Phone: 503-517-8663 | Fax: | ||||||||||||
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