Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 19-QMHPC-00812 | OR |
NPI | 1003103359 |
---|---|
Provider Name | Donna M Turquoise |
First Address | Portland, OR 97205-1715 |
Second Address | Portland, OR 97201-2522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500641469 | (05) | OR |