Provider Demographics
NPI:1932356623
Name:DANNER, SANKIRTANA MUNDLAPUDI
Entity Type:Individual
Prefix:
First Name:SANKIRTANA
Middle Name:MUNDLAPUDI
Last Name:DANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 SE BASELINE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4103
Mailing Address - Country:US
Mailing Address - Phone:503-640-4222
Mailing Address - Fax:
Practice Address - Street 1:447 SE BASELINE ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4103
Practice Address - Country:US
Practice Address - Phone:503-640-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)