Individual
DONNA MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, QMHP
Contact information
Practice address
400 NE 7TH ST, GRESHAM, OR 97030-5604
(503) 661-5455
(503) 661-4959
Mailing address
130 NW LINNEMAN AVE, GRESHAM, OR 97030
(503) 260-6809
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07-09-02
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
11/28/2007
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