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NPI Code Detail

MEDICARE: ADRIENNE LEIGH ISGRIGG M.S.

MEDICARE: ADRIENNE LEIGH ISGRIGG M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YA0400XAddiction (Substance Use Disorder) CounselorOR

General Provider Information

NPI Number : 1417220971
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE LEIGH ISGRIGG M.S.
Provider Business Mailing Address
First Line : 7525 SE LAKE RD
Second Line :
City : MILWAUKIE
State : OR
Zip : 97267-2115
Country : US
Telephone Number : 503-303-4014
Fax Number :
Provider Business Practice Location Address
First Line : 7525 SE LAKE RD
Second Line :
City : MILWAUKIE
State : OR
Zip : 97267-2115
Country : US
Telephone Number : 503-303-4000
Fax Number : 503-344-4412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2012
Last Update Date : 06/08/2012

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