Provider Demographics
NPI:1659603561
Name:MATTSON, TERRA ANN (MA MFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:TERRA
Middle Name:ANN
Last Name:MATTSON
Suffix:
Gender:F
Credentials:MA MFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SW MEADOWS RD
Mailing Address - Street 2:SUITE 361
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4264
Mailing Address - Country:US
Mailing Address - Phone:503-679-4743
Mailing Address - Fax:
Practice Address - Street 1:4800 SW MEADOWS RD
Practice Address - Street 2:SUITE 361
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4264
Practice Address - Country:US
Practice Address - Phone:503-679-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional