Provider Demographics
NPI:1083433221
Name:LUANN FOSTER PSYD LLC
Entity type:Organization
Organization Name:LUANN FOSTER PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:971-268-0807
Mailing Address - Street 1:2120 E PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-4009
Mailing Address - Country:US
Mailing Address - Phone:971-268-0807
Mailing Address - Fax:
Practice Address - Street 1:515 N VILLA RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1832
Practice Address - Country:US
Practice Address - Phone:971-268-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)