Healthcare Provider Details

I. General information

NPI: 1255844676
Provider Name (Legal Business Name): LAURA C DUNN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA C WHITCOMB

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 NW OTIE ST
ROSEBURG OR
97470-1948
US

IV. Provider business mailing address

1820 NW OTIE ST
ROSEBURG OR
97470-1948
US

V. Phone/Fax

Practice location:
  • Phone: 720-323-6305
  • Fax:
Mailing address:
  • Phone: 720-323-6305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number24-R-31
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC9467
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC9467
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: