Individual
ELIJAH ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030-5770
(503) 740-1971
(503) 771-2436
Mailing address
10117 SE SUNNYSIDE RD # F1217, CLACKAMAS, OR 97015-7708
(503) 740-1971
(503) 771-2486
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-CRM3164
OR
Other
Enumeration date
05/27/2025
Last updated
06/13/2025
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