Individual
BROOKE ANSOTEGUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 SW 68TH PKWY STE 200, TIGARD, OR 97223-9058
(541) 561-7039
Mailing address
336 NE BOARDMAN AVE, BOARDMAN, OR 97818-9703
(541) 561-7039
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
R8873
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/29/2018
Last updated
06/21/2024
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