Provider Demographics
NPI:1306075841
Name:ADAMS SUTRO, DAWN HELEN (MED, LMFT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:HELEN
Last Name:ADAMS SUTRO
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4840
Mailing Address - Country:US
Mailing Address - Phone:541-738-0866
Mailing Address - Fax:541-752-9464
Practice Address - Street 1:699 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4840
Practice Address - Country:US
Practice Address - Phone:541-738-0866
Practice Address - Fax:541-752-9464
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0479106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist