Individual
ANISSA RENEE BAHRENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2133 NE BROADWAY ST STE 303, PORTLAND, OR 97232-1878
(503) 807-2912
Mailing address
8040 SE 35TH AVE, PORTLAND, OR 97202-8414
(503) 807-2912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4419
OR
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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