Individual
ANDREA DAWN LOMMASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229
(503) 645-3581
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13-06-39
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-06-39
ACCBO
—
Enumeration date
03/20/2012
Last updated
08/02/2018
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