Provider Demographics
NPI:1467644971
Name:FALKENSTEIN, PATTY ANN (CADC PENDING, AA)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:FALKENSTEIN
Suffix:
Gender:F
Credentials:CADC PENDING, AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11895 SW GREENBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-726-3832
Mailing Address - Fax:503-726-3833
Practice Address - Street 1:11895 SW GREENBURG ROAD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-726-3832
Practice Address - Fax:503-726-3833
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)