Healthcare Provider Details

I. General information

NPI: 1457368557
Provider Name (Legal Business Name): DEANNA ENGBER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5291 NE ELAM YOUNG PKWY STE 160
HILLSBORO OR
97124-7560
US

IV. Provider business mailing address

113 N ELM ST
CANBY OR
97013-3519
US

V. Phone/Fax

Practice location:
  • Phone: 503-372-5147
  • Fax: 503-640-4001
Mailing address:
  • Phone: 503-263-8903
  • Fax: 503-266-8632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC4978
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: