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General NPI Number Information
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NPI Number | 1649897844
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Entity Type | Individual
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Provider Name | ANTHONY MICHAEL ZANOLLI LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 4805 NE GLISAN ST
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City | PORTLAND
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State | OR
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Zip | 97213-2933
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Country | US
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Telephone | 503-215-1111
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Fax | 503-215-6987
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Provider Business Mailing Address
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Address Line | 9823 SE CORA ST
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City | PORTLAND
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State | OR
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Zip | 97266-2524
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Country | US
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Telephone | 503-944-9996
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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 | L7650
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License Number State | OR
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