Healthcare Provider Details

I. General information

NPI: 1285548222
Provider Name (Legal Business Name): ALEXIS SIDNEY OLLENBROOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NE COMPTON DR
HILLSBORO OR
97006-2291
US

IV. Provider business mailing address

123 SW STRINGTOWN RD
FOREST GROVE OR
97116-7300
US

V. Phone/Fax

Practice location:
  • Phone: 503-640-5352
  • Fax:
Mailing address:
  • Phone: 503-449-4887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: