Healthcare Provider Details

I. General information

NPI: 1982169934
Provider Name (Legal Business Name): MONICA ELAINE DREWER-TABACCHI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6622 SE RHONE ST
PORTLAND OR
97206-2640
US

IV. Provider business mailing address

6622 SE RHONE ST
PORTLAND OR
97206-2640
US

V. Phone/Fax

Practice location:
  • Phone: 503-467-8398
  • Fax:
Mailing address:
  • Phone: 503-467-8398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC5179
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: