Provider Demographics
NPI:1053043547
Name:ANDERSON, ARIEL LEIGH (MA)
Entity Type:Individual
Prefix:MISS
First Name:ARIEL
Middle Name:LEIGH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 SE CHERRY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2821
Mailing Address - Country:US
Mailing Address - Phone:503-535-1151
Mailing Address - Fax:
Practice Address - Street 1:10230 SE CHERRY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2821
Practice Address - Country:US
Practice Address - Phone:503-535-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health