Healthcare Provider Details

I. General information

NPI: 1679205421
Provider Name (Legal Business Name): MOLLY BOWEN MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MOLLY BOWEN MA, LPC

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 INDUSTRIAL ST
HOOD RIVER OR
97031-2236
US

IV. Provider business mailing address

PO BOX 82174
PORTLAND OR
97282-0174
US

V. Phone/Fax

Practice location:
  • Phone: 971-350-9027
  • Fax:
Mailing address:
  • Phone: 971-350-9027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: