Healthcare Provider Details

I. General information

NPI: 1578206280
Provider Name (Legal Business Name): DANA JEANNE SLAUGHTERBECK CPM, LDM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SW CAMELOT CT
PORTLAND OR
97225-3700
US

IV. Provider business mailing address

18408 SW SUGARLOAF LN
BEAVERTON OR
97007-3013
US

V. Phone/Fax

Practice location:
  • Phone: 503-252-8125
  • Fax: 503-256-8422
Mailing address:
  • Phone: 813-361-5335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberDEM-LD-10217493
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: