Healthcare Provider Details

I. General information

NPI: 1356245534
Provider Name (Legal Business Name): SETH DOZIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58646 MCNULTY WAY
SAINT HELENS OR
97051-6210
US

IV. Provider business mailing address

5230 NE 28TH AVE
PORTLAND OR
97211-6232
US

V. Phone/Fax

Practice location:
  • Phone: 503-397-5211
  • Fax: 503-397-5373
Mailing address:
  • Phone: 314-322-4546
  • Fax: 503-397-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: