Healthcare Provider Details

I. General information

NPI: 1356714471
Provider Name (Legal Business Name): HANNAH ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2015
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4685 GALEWOOD ST APT D
LAKE OSWEGO OR
97035-2454
US

IV. Provider business mailing address

4685 GALEWOOD ST APT D
LAKE OSWEGO OR
97035-2454
US

V. Phone/Fax

Practice location:
  • Phone: 503-718-8294
  • Fax:
Mailing address:
  • Phone: 503-718-8294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180013714
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: