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General NPI Number Information
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NPI Number | 1578184289
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Entity Type | Individual
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Provider Name | HANNAH BUSHNER
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Gender | Female
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 4900 MEADOWS RD STE 250
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-3173
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Country | US
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Telephone | 503-305-5064
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Fax | 855-750-2962
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Provider Business Mailing Address
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Address Line | 6609 SE TOLMAN ST
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City | PORTLAND
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State | OR
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Zip | 97206-6639
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L8631
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License Number State | OR
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