Individual provider · Type 1 NPI

Sally Foster Rudolph, MA

Mental Health Counselor · Portland, OR

NPI number 1780984930 Active

Practice location

1500 NE Irving St, Suite 250
Portland, OR 97232-2243

Mailing address

4628 SE 47th Ave
Portland, OR 97206-4136

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1780984930

Sally Foster Rudolph, MA's National Provider Identifier is 1780984930, issued on Oct 21, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Oct 21, 2010.