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General NPI Number Information
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NPI Number | 1174833024
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Entity Type | Individual
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Provider Name | NAIYANA CHANTARABUNCHORN PHD, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 02/09/2019
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Provider Practice Location Address
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Address Line | 1915 NE STUCKI AVE STE 400
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City | HILLSBORO
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State | OR
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Zip | 97006-6938
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Country | US
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Telephone | 971-238-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 NE STUCKI AVE STE 400
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City | HILLSBORO
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State | OR
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Zip | 97006-6938
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Country | US
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Telephone | 971-238-4990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8549
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C2684
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License Number State | OR
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