Donna Marie Anderson, MSW, QMHP

Individual provider Active NPI Clinical Social Worker · Gresham, OR

NPI 1053335398 · NPPES record last updated Nov 28, 2007

Key facts

NPI
1053335398
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
400 NE 7TH St
Gresham, OR 97030-5604
Phone
(503) 661-5455
Fax
(503) 661-4959
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Yes
Addiction (Substance Use Disorder) Counselor 101YA0400X 07-09-02 OR

Addresses

Primary practice location

400 NE 7TH St
Gresham, OR 97030-5604

Mailing address

130 NW Linneman Ave
Gresham, OR 97030
Phone (503) 260-6809

Other providers in Gresham, OR

All providers in Gresham, OR · Clinical Social Worker in Oregon

Sources for this page

Verify at the official NPI Registry.