Provider Demographics
NPI:1417392366
Name:BARTH, DANIELLE SHARAYAH (MSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SHARAYAH
Last Name:BARTH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12508 SW 171ST TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-2056
Mailing Address - Country:US
Mailing Address - Phone:503-936-0259
Mailing Address - Fax:
Practice Address - Street 1:1 JEFFERSON PKWY
Practice Address - Street 2:APT 44
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8847
Practice Address - Country:US
Practice Address - Phone:503-936-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical