Healthcare Provider Details

I. General information

NPI: 1699974998
Provider Name (Legal Business Name): ANDREA MARIE GIFFORD MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 W OREGON AVE
CRESWELL OR
97426-9605
US

IV. Provider business mailing address

PO BOX 395
CRESWELL OR
97426-0395
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-7234
  • Fax: 541-216-4915
Mailing address:
  • Phone: 541-357-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: