Healthcare Provider Details

I. General information

NPI: 1831954981
Provider Name (Legal Business Name): DAWN FORRESTER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 8TH ST
GRESHAM OR
97030-6941
US

IV. Provider business mailing address

900 NW 8TH ST
GRESHAM OR
97030-6941
US

V. Phone/Fax

Practice location:
  • Phone: 503-896-0869
  • Fax:
Mailing address:
  • Phone: 503-896-0869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC11358
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: