Healthcare Provider Details

I. General information

NPI: 1811062706
Provider Name (Legal Business Name): MARY DAVEY DOWER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51891 OLD PORTLAND RD SUITE B
SCAPPOOSE OR
97056
US

IV. Provider business mailing address

14777 NW MCNAMEE RD
PORTLAND OR
97231-2133
US

V. Phone/Fax

Practice location:
  • Phone: 503-796-1116
  • Fax: 503-621-3703
Mailing address:
  • Phone: 503-621-3703
  • Fax: 503-621-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2740
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: