Healthcare Provider Details

I. General information

NPI: 1003030610
Provider Name (Legal Business Name): LAURA ANN ALLEN MS, CADCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA ANN BURWELL MS, CADCIII

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10763 SW GREENBURG RD STE 100
TIGARD OR
97223-5492
US

IV. Provider business mailing address

10763 SW GREENBURG RD STE 100
TIGARD OR
97223-5492
US

V. Phone/Fax

Practice location:
  • Phone: 503-684-8159
  • Fax: 503-598-0934
Mailing address:
  • Phone: 503-684-8159
  • Fax: 503-598-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number06-11-73
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: