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General NPI Number Information
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NPI Number | 1972460756
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Entity Type | Organization
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Legal Business Name | HIDDEN TRAILS THERAPY LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 5020 NE M L KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97211-3204
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Country | US
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Telephone | 971-271-1875
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Fax |
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Provider Business Mailing Address
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Address Line | 12363 SE HUBBARD RD
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City | CLACKAMAS
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State | OR
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Zip | 97015-8219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY YVONNE VANDE SLUNT
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Credential |
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Telephone | 971-271-1875
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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 |
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License Number State |
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