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NPI Code Detail

MEDICARE: ALICIA JILL ANDERSON

MEDICARE: ALICIA JILL ANDERSON
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
1106H00000XMarriage & Family TherapistR10744OR

General Provider Information

NPI Number : 1922806405
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA JILL ANDERSON
Provider Business Mailing Address
First Line : 1915 NE STUCKI AVE STE 305
Second Line :
City : HILLSBORO
State : OR
Zip : 97006-8041
Country : US
Telephone Number : 541-807-0690
Fax Number :
Provider Business Practice Location Address
First Line : 1915 NE STUCKI AVE STE 305
Second Line :
City : HILLSBORO
State : OR
Zip : 97006-8041
Country : US
Telephone Number : 541-807-0690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2025
Last Update Date : 03/03/2025

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Directions to “ ALICIA JILL ANDERSON ” Practice Location

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