Provider Demographics
NPI:1770452286
Name:FOX NUNN, BETH ANNE
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:FOX NUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14231 S MACKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-8402
Mailing Address - Country:US
Mailing Address - Phone:503-913-9598
Mailing Address - Fax:503-913-9598
Practice Address - Street 1:10151 SE SUNNYSIDE RD STE 480
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5705
Practice Address - Country:US
Practice Address - Phone:503-739-8321
Practice Address - Fax:971-209-7172
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR9361101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional