Healthcare Provider Details

I. General information

NPI: 1174943534
Provider Name (Legal Business Name): AMY ANN MCCLUNG LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SW CEDAR HILLS BLVD STE 280B
BEAVERTON OR
97005-2039
US

IV. Provider business mailing address

3800 SW CEDAR HILLS BLVD STE 280B
BEAVERTON OR
97005-2039
US

V. Phone/Fax

Practice location:
  • Phone: 360-600-5877
  • Fax:
Mailing address:
  • Phone: 360-600-5887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2748
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT0821
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number6067
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: