Provider Demographics
NPI:1487775607
Name:RUTHERFORD, KAREN SCOTT (CADC II)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SCOTT
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 SW BRYSON ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-1302
Mailing Address - Country:US
Mailing Address - Phone:503-623-6704
Mailing Address - Fax:
Practice Address - Street 1:182 SW ACADEMY ST STE 310
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1900
Practice Address - Country:US
Practice Address - Phone:503-623-9289
Practice Address - Fax:503-623-2731
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96-04-61101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)