Provider Demographics
NPI:1851507768
Name:MORRISON, JEANETTE (MSW)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:
Other - Last Name:AANDERUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:10090 SW HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4602
Mailing Address - Country:US
Mailing Address - Phone:503-430-8970
Mailing Address - Fax:
Practice Address - Street 1:10090 SW HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-4602
Practice Address - Country:US
Practice Address - Phone:503-430-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5704558-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker