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General NPI Number Information
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NPI Number | 1508773540
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Entity Type | Individual
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Provider Name | AMANDA ELIZABETH IRWIN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 3400 NE JOHN OLSEN AVE STE 200
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City | HILLSBORO
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State | OR
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Zip | 97124-5817
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Country | US
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Telephone | 971-202-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 607 SE 15TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-2604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A18667
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A18667
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License Number State | OR
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