Individual
ANNA NOWICKIWEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 SE 151ST AVE, PORTLAND, OR 97233-2916
(971) 271-7270
(971) 302-6046
Mailing address
805 SE 151ST AVE, PORTLAND, OR 97233-2916
(971) 271-7270
(971) 302-6046
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245624253
ORGANIZATION
OR
Enumeration date
10/17/2014
Last updated
01/22/2016
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