Provider Demographics
NPI:1619165677
Name:EGGERS, KAREN ANN (MSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:EGGERS
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 1:2315 PACIFIC AVE
Mailing Address - Street 2:303
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2449
Mailing Address - Country:US
Mailing Address - Phone:503-730-1454
Mailing Address - Fax:
Practice Address - Street 1:2315 PACIFIC AVE
Practice Address - Street 2:303
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2449
Practice Address - Country:US
Practice Address - Phone:503-730-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL06741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical