Provider Demographics
NPI:1881479764
Name:VON DOLLEN, ZOE
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:VON DOLLEN
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 1:2105 NE CESAR E CHAVEZ BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-5434
Mailing Address - Country:US
Mailing Address - Phone:503-836-8836
Mailing Address - Fax:503-836-8836
Practice Address - Street 1:2105 NE CESAR E CHAVEZ BLVD STE 270
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-5434
Practice Address - Country:US
Practice Address - Phone:503-836-8836
Practice Address - Fax:503-836-8836
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical