Provider Demographics
NPI:1598258907
Name:LUND, AMELIA (LMFT)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:LUND
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 SW 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1421
Mailing Address - Country:US
Mailing Address - Phone:801-688-8014
Mailing Address - Fax:
Practice Address - Street 1:7225 SW 51ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1421
Practice Address - Country:US
Practice Address - Phone:801-688-8014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1904106H00000X
UT10675178-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist