Provider Demographics
NPI:1356451389
Name:PRICE, ANDREW P (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:PRICE
Suffix:
Gender:M
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 1:2304 E BURNSIDE ST
Mailing Address - Street 2:STE. 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1677
Mailing Address - Country:US
Mailing Address - Phone:503-238-6007
Mailing Address - Fax:503-238-6007
Practice Address - Street 1:2304 E BURNSIDE ST
Practice Address - Street 2:STE. 202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1677
Practice Address - Country:US
Practice Address - Phone:503-238-6007
Practice Address - Fax:503-238-6007
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR33441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical