Healthcare Provider Details

I. General information

NPI: 1033022793
Provider Name (Legal Business Name): HALEY CHRISTINE LADOUCEUR 11BBBE05-FF7E-4A50-8
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SW CARSON ST
PORTLAND OR
97219-4632
US

IV. Provider business mailing address

225 SW CARSON ST
PORTLAND OR
97219-4632
US

V. Phone/Fax

Practice location:
  • Phone: 760-674-6428
  • Fax:
Mailing address:
  • Phone: 760-674-6428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: