Healthcare Provider Details

I. General information

NPI: 1568926368
Provider Name (Legal Business Name): ADRIANA VILLEGAS GARIBAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 11/13/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11740 SW 68TH PKWY STE 200
TIGARD OR
97223-9058
US

IV. Provider business mailing address

1162 POST OFFICE
ALBANY OR
97321-9777
US

V. Phone/Fax

Practice location:
  • Phone: 425-640-7009
  • Fax:
Mailing address:
  • Phone: 503-967-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL30011
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: