MEDICARE: AARON RAY GARNER

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
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	109390	OTHER	TX	TEXAS LICENSE
2	11000	OTHER	OR	OREGON LICENSE

General Provider Information

NPI Number	:	1477019768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON RAY GARNER

Provider Business Mailing Address
First Line	:	119 DOWNING DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-6405
Country	:	US
Telephone Number	:	105-705-3552
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 NW FLANDERS ST STE 101
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-5409
Country	:	US
Telephone Number	:	210-570-5355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	07/15/2025

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