Provider Demographics
NPI:1245637602
Name:DORNBLASER, BARBARA JOAN (STUDENT INTERN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOAN
Last Name:DORNBLASER
Suffix:
Gender:F
Credentials:STUDENT INTERN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JOAN
Other - Last Name:GUENTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 N BRUTSCHER ST # D141
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-6096
Mailing Address - Country:US
Mailing Address - Phone:718-640-9529
Mailing Address - Fax:
Practice Address - Street 1:11845 SW GREENBURG RD STE 210
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6464
Practice Address - Country:US
Practice Address - Phone:971-864-0952
Practice Address - Fax:971-266-4521
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No372600000XNursing Service Related ProvidersAdult Companion