Provider Demographics
NPI:1659520310
Name:MONROE, MINA (MSW MPH)
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:MSW MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10180 SE SUNNYSIDE ROAD
Mailing Address - Street 2:KAISER SUNNYSIDE MEDICAL CENTER SOCIAL WORK DEPARTMENT
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9303
Mailing Address - Country:US
Mailing Address - Phone:503-331-5213
Mailing Address - Fax:503-331-5044
Practice Address - Street 1:10180 SE SUNNYSIDE ROAD
Practice Address - Street 2:KAISER SUNNYSIDE MEDICAL CENTER SOCIAL WORK DEPARTMENT
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9303
Practice Address - Country:US
Practice Address - Phone:503-331-5213
Practice Address - Fax:503-331-5044
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker