Provider Demographics
NPI:1265449631
Name:ANDERSON, MARGRET LILLIAS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGRET
Middle Name:LILLIAS
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:7600 NE 41ST ST STE 310
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6791
Mailing Address - Country:US
Mailing Address - Phone:503-319-5858
Mailing Address - Fax:
Practice Address - Street 1:7600 NE 41ST ST STE 310
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6791
Practice Address - Country:US
Practice Address - Phone:503-319-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000077121041C0700X
ORL18031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR11951Medicare ID - Type Unspecified