Annette Doreen Anderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ontario, OR
NPI 1104669159 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1104669159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 24-CRM-3300 (OR)
- Practice address
- PO Box 658
Ontario, OR 97914-0658 - Phone
- (541) 216-6068
- Fax
- (541) 216-6094
- NPI assigned
- Jun 17, 2024
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-CRM-3300 | OR | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 24-CRM-3300 | OR | Yes |
Addresses
Primary practice location
PO Box 658
Ontario, OR 97914-0658
Mailing address
Altruistic Recovery 1052 SW 4TH Avenue #2
PO Box 658
Ontario, OR 97914-0658
Phone (541) 216-6068
Other providers in Ontario, OR
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- Stephen K Ames
- James Dwight Anderson
- Sheridan Marie Anderson
- Steven Blaine Anderson
- Sarah Andrade
- Kacey L Andreasen
All providers in Ontario, OR · Addiction (Substance Use Disorder) Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.