Provider Demographics
NPI:1073863973
Name:ATTERBERRY, AMY A
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:A
Last Name:ATTERBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4585 SW 185TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-1557
Mailing Address - Country:US
Mailing Address - Phone:503-619-1921
Mailing Address - Fax:503-848-2072
Practice Address - Street 1:4585 SW 185TH AVE
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97007-1557
Practice Address - Country:US
Practice Address - Phone:503-619-1921
Practice Address - Fax:503-848-2072
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker