MEDICARE: SUNNY A. HUNTER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	C2202	OR

General Provider Information

NPI Number	:	1588815872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNNY A. HUNTER LPC

Provider Business Mailing Address
First Line	:	3615 N FARRAGUT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-5954
Country	:	US
Telephone Number	:	503-679-0784
Fax Number	:

Provider Business Practice Location Address
First Line	:	3615 N FARRAGUT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-5954
Country	:	US
Telephone Number	:	503-679-0784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2008
Last Update Date	:	01/08/2010

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