Provider Demographics
NPI:1417220971
Name:ISGRIGG, ADRIENNE LEIGH (MS)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LEIGH
Last Name:ISGRIGG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 SE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2115
Mailing Address - Country:US
Mailing Address - Phone:503-303-4014
Mailing Address - Fax:
Practice Address - Street 1:7525 SE LAKE RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2115
Practice Address - Country:US
Practice Address - Phone:503-303-4000
Practice Address - Fax:503-344-4412
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)