Individual provider Active NPI

Amy Dawnell Pullen, LMFT

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1962650598
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T0412 Issued in OR
Practice address
604 NW 23Rd Ave Ste 4
Portland, OR 97210-3209
Phone
(503) 247-8000
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X T0412 OR Primary

Addresses

Primary practice location

604 NW 23Rd Ave Ste 4
Portland, OR 97210-3209

Mailing address

604 NW 23Rd Ave Ste 4
Portland, OR 97210-3209
Phone (503) 247-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T0412ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1962650598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 NW 23RD AVE STE 4",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103209",
            "telephone_number": "503-247-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 NW 23RD AVE STE 4",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103209",
            "telephone_number": "503-247-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "AMY",
        "middle_name": "DAWNELL",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "T0412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.