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Individual

ANNA RUTH BOOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
15110 BOONES FERRY RD STE 240, LAKE OSWEGO, OR 97035
(503) 781-6938
(503) 230-8884
Mailing address
15110 BOONES FERRY RD STE 240, LAKE OSWEGO, OR 97035-3497
(503) 781-6938
(503) 230-8884

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500664078
OR
Enumeration date
01/26/2007
Last updated
07/25/2019
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