Basic Information
Provider Information
NPI: 1003151341
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DURFEE
FirstName: DENNIS
MiddleName: MICHAEL
NamePrefix: MR.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5785
Address2:  
City: SALEM
State: OR
PostalCode: 973040785
CountryCode: US
TelephoneNumber: 5039492819
FaxNumber:  
Practice Location
Address1: 7290 RIDGEWAY RD
Address2:  
City: SHERIDAN
State: OR
PostalCode: 973789531
CountryCode: US
TelephoneNumber: 5039492819
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/27/2012
LastUpdateDate: 09/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X8741191ORN Behavioral Health & Social Service ProvidersCounselor 
101YM0800X87461191ORY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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