Individual provider · Type 1 NPI

Annastacia Desiree Weiss

Mental Health Counselor · Portland, OR

NPI number 1619523255 Active

Practice location

12121 E Burnside St
Portland, OR 97216-3737

Mailing address

232 NW 6th Ave
Portland, OR 97209-3609

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X19-QMHA-I-02193 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1619523255

Annastacia Desiree Weiss's National Provider Identifier is 1619523255, issued on Aug 9, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Aug 9, 2019.