Provider Demographics
NPI:1992923445
Name:AANDERUD, PATRICIA (MSW LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:AANDERUD
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10090 SW HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4602
Mailing Address - Country:US
Mailing Address - Phone:503-430-8970
Mailing Address - Fax:
Practice Address - Street 1:7080 SW FIR LOOP STE 100
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8149
Practice Address - Country:US
Practice Address - Phone:503-620-1191
Practice Address - Fax:503-620-3940
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL33931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical