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NPI Code Detail

MEDICARE: DR. ANDREA MICHELLE ORTEGA-CRIDDLE PSY.D

MEDICARE: DR. ANDREA MICHELLE ORTEGA-CRIDDLE PSY.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TH0100XHealth Service Psychologist

General Provider Information

NPI Number : 1457019978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA MICHELLE ORTEGA-CRIDDLE PSY.D
Provider Business Mailing Address
First Line : 21900 WILLAMETTE DR STE 202
Second Line :
City : WEST LINN
State : OR
Zip : 97068-3284
Country : US
Telephone Number : 805-598-1533
Fax Number :
Provider Business Practice Location Address
First Line : 21900 WILLAMETTE DR STE 202
Second Line :
City : WEST LINN
State : OR
Zip : 97068-3284
Country : US
Telephone Number : 503-653-0631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2021
Last Update Date : 06/02/2026

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Directions to “ DR. ANDREA MICHELLE ORTEGA-CRIDDLE PSY.D” Practice Location

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