Provider Demographics
NPI:1376370684
Name:SPANIER, BETHANY JOY (CSWA)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOY
Last Name:SPANIER
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:JOY
Other - Last Name:SIEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7105 SW VARNS ST STE 205
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8148
Mailing Address - Country:US
Mailing Address - Phone:503-479-2888
Mailing Address - Fax:
Practice Address - Street 1:7105 SW VARNS ST STE 205
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8148
Practice Address - Country:US
Practice Address - Phone:503-479-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA159021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical