MEDICARE: MR. ROBERT BASKIN ANDERSON LPC, CADC III

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor	C1855	OR

General Provider Information

NPI Number	:	1831398130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT BASKIN ANDERSON LPC, CADC III

Provider Business Mailing Address
First Line	:	16869 LAKERIDGE DR
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-6831
Country	:	US
Telephone Number	:	503-997-3394
Fax Number	:

Provider Business Practice Location Address
First Line	:	4248 GALEWOOD ST STE 18
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-2405
Country	:	US
Telephone Number	:	503-997-3394
Fax Number	:	888-690-0820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	02/02/2024

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