Healthcare Provider Details

I. General information

NPI: 1457269086
Provider Name (Legal Business Name): ANDREA LYNNE RAPP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13455 SE 97TH AVE
CLACKAMAS OR
97015-8662
US

IV. Provider business mailing address

13455 SE 97TH AVE
CLACKAMAS OR
97015-8662
US

V. Phone/Fax

Practice location:
  • Phone: 503-675-4000
  • Fax: 503-652-4452
Mailing address:
  • Phone: 503-675-4000
  • Fax: 503-652-4452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL3757
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: