Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Dimitri Fuller

Individual provider Mental Health Counselor · NPI 1053245589

Mr. Dimitri Fuller is a Mental Health Counselor in Canby, Oregon. Licensed in Oregon. Registered with an NPI since 2026.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

22018 S Central Point Rd
Canby, OR 97013-8705
Phone: (503) 221-4531
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (OR)

Record details

NPI number1053245589
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 10, 2026
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address1227 Johnson St, Oregon City, OR 97045-3610

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