MEDICARE: TONIA M COTTRELL LCSW

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	61382336	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891859971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONIA M COTTRELL LCSW

Provider Business Mailing Address
First Line	:	PO BOX 3396
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3396
Country	:	US
Telephone Number	:	503-233-5405
Fax Number	:	503-233-2696

Provider Business Practice Location Address
First Line	:	4449 EASTON WAY FL 2
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-7005
Country	:	US
Telephone Number	:	614-665-5443
Fax Number	:	999-999-9999

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	03/05/2026

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Directions to “ TONIA M COTTRELL LCSW” Practice Location

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