Provider Demographics
NPI:1467883371
Name:ASSASNIK, AMIR ALEXANDER (LCSW)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:ALEXANDER
Last Name:ASSASNIK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 NW CORNELL RD # 220
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7334
Mailing Address - Country:US
Mailing Address - Phone:971-500-6799
Mailing Address - Fax:503-922-6676
Practice Address - Street 1:16100 NW CORNELL RD # 220
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7334
Practice Address - Country:US
Practice Address - Phone:503-878-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL107351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical