Portland Trauma and Dissociation Specialists LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PORTLAND TRAUMA AND DISSOCIATION SPECIALISTS LLC

Practice address

1831 SE 7TH Ave
Portland, OR 97214-3578

Phone

(971) 895-1751

NPI assigned

Aug 18, 2025

Last updated

Aug 18, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Heather Lynn Lafontaine, LCSWNPI 1073261392

Title

Co-Owner/Provider

Phone

(971) 895-1751

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Lynn Lafontaine, CSWA

  • Clinical Social Worker
  • Portland, OR
  • NPI 1073261392
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1619854148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14701",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972930701",
            "telephone_number": "971-895-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 SE 7TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143578",
            "telephone_number": "971-895-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND TRAUMA AND DISSOCIATION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "LAFONTAINE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CO-OWNER/PROVIDER",
        "authorized_official_telephone_number": "971-895-1751",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portland Surgical Specialists, PC
• Portland Therapy Project LLC
• Portland Therapy Solutions, LLC
• Portland Tissue Processing Laboratory, Inc.
• Portland Traditional Acupuncture
• Portland Trauma Recovery, LLC
• Portland VA Medical Center
• Portland VA Medical Center
• Portland VA Medical Center
• Portland VA Medical Center

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.