Provider Demographics
NPI:1225409105
Name:ANDERSON, DEANNA L (MSW)
Entity type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1952 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-4045
Mailing Address - Country:US
Mailing Address - Phone:360-423-0203
Mailing Address - Fax:
Practice Address - Street 1:1952 9TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4045
Practice Address - Country:US
Practice Address - Phone:360-423-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker