| Sundance Counseling West Llc | |
|
201 B Ave Ste 295 Lake Oswego OR 97034-3290 | |
| (503) 616-1101 | |
| (503) 334-4379 |
| Full Name | Sundance Counseling West Llc |
|---|---|
| Speciality | Social Worker |
| Location | 201 B Ave Ste 295, Lake Oswego, Oregon |
| Authorized Official Name and Position | Allison Blomquist Christianson (OWNER / PRACTITIONER) |
| Authorized Official Contact | 5036161101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sundance Counseling West Llc 17218 S Ramsby Rd Molalla OR 97038-7634 Ph: (503) 616-1101 | Sundance Counseling West Llc 201 B Ave Ste 295 Lake Oswego OR 97034-3290 Ph: (503) 616-1101 |
| NPI Number | 1285260471 |
|---|---|
| Provider Enumeration Date | 03/19/2020 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 5092127415 |
|---|---|
| Medicare Enrollment ID | O20201209000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285260471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Allison Blomquist Christianson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225692999 PECOS PAC ID: 1658602834 Enrollment ID: I20201209000562 |
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