Healthcare Provider Details

I. General information

NPI: 1760917439
Provider Name (Legal Business Name): MARGARET H ANDERSON PSY D PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 DRY HOLLOW RD STE 2
THE DALLES OR
97058-3167
US

IV. Provider business mailing address

PO BOX 1102
GOLDENDALE WA
98620-1102
US

V. Phone/Fax

Practice location:
  • Phone: 541-298-2298
  • Fax: 855-647-9624
Mailing address:
  • Phone: 541-298-2298
  • Fax: 855-647-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1820
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number1820
License Number StateOR

VIII. Authorized Official

Name: DR. MARGARET H ANDERSON
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSY.D.
Phone: 541-298-2298