Individual
ANDREA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 SW MACADAM AVE, SUITE 400, PORTLAND, OR 97239-6102
(971) 244-1363
Mailing address
5100 SW MACADAM AVE, SUITE 400, PORTLAND, OR 97239-6102
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M5485
OR
1041C0700X
Clinical Social Worker
Primary
A5485
OR
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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