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General NPI Number Information
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NPI Number | 1992765887
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Entity Type | Individual
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Provider Name | SANDRA C ANDERSON MSW PHD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 962 NW KEARNEY SUITE 106
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City | PORTLAND
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State | OR
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Zip | 97209
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Country | US
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Telephone | 503-725-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 14571 NW LARSON ROAD
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City | PORTLAND
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State | OR
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Zip | 97231-2320
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Country | US
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Telephone | 503-297-1777
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Fax | 503-297-5996
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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 | LCSW61
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License Number State | OR
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