Individual
BLAINE DAVID ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
(503) 397-5373
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
(503) 397-5211
(503) 397-5373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CL60214957
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123190
—
OR
Enumeration date
10/24/2012
Last updated
04/23/2018
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