Provider Demographics
NPI:1144020694
Name:DUFORT, DEBORA DAWN (PWS)
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:DAWN
Last Name:DUFORT
Suffix:
Gender:F
Credentials:PWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51600 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LA PINE
Mailing Address - State:OR
Mailing Address - Zip Code:97739-8887
Mailing Address - Country:US
Mailing Address - Phone:541-536-3435
Mailing Address - Fax:
Practice Address - Street 1:51600 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:LA PINE
Practice Address - State:OR
Practice Address - Zip Code:97739-8887
Practice Address - Country:US
Practice Address - Phone:541-536-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist