MR. PHILIP DEAN ANDERSON MS09/10/1952 - NPI 1205911138

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

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About Mr. Philip Dean Anderson Ms09/10/1952 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PHILIP DEAN ANDERSON MS09/10/1952 (NPI 1205911138) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (96-04-02) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1205911138

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. PHILIP DEAN ANDERSONCredential: MS09/10/1952

Location Address3325 N INTERSTATE AVEPortland, OR 97227-1020

Mailing Address3325 N Interstate AvePortland, OR 97227-1020 · (503) 285-9321

Phone(503) 285-9321

Sole ProprietorNo

Enumeration DateOctober 26, 2006

Last NPPES UpdateJuly 12, 2007

✔ NPI 1205911138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OR · 96-04-02

3325 N INTERSTATE AVE, Portland, OR 97227

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHERYL A MIRANDA MS

Genetic Counselor, MS