Basic Information
| Provider Information | |||||||||
| NPI: | 1902564669 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUSTIN | ||||||||
| FirstName: | ADRIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6149 | ||||||||
| Address2: | |||||||||
| City: | ALOHA | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970070149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033528642 | ||||||||
| FaxNumber: | 5033528658 | ||||||||
| Practice Location | |||||||||
| Address1: | 1151 N ADAIR ST | ||||||||
| Address2: | |||||||||
| City: | CORNELIUS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971138900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033595564 | ||||||||
| FaxNumber: | 5033574371 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2021 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A12751 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.