DOMINIQUE PAGE DUBOIS MSW NPI 1477854073

NPI Information

NPI: 1477854073
Provider Name: DOMINIQUE PAGE DUBOIS, MSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
12790 SE STARK ST
PORTLAND, OR
ZIP 97233
Phone: (503) 328-1512
Get Directions

Dominique Page Dubois, MSW is a mental health counselor in Portland, OR. Dominique Page Dubois, MSW NPI is 1477854073. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12790 SE STARK ST
PORTLAND, OR
ZIP 97233-552
Phone: (503) 328-1512
Fax: (503) 238-2436

The NPI 1477854073 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/12/2010 and was last updated on 8/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	390200000X	Student in an Organized Health Care Education/Training Program				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	123190	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »