Provider Demographics
NPI:1174701247
Name:CROSKEY, ANDREA DENISE (BA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DENISE
Last Name:CROSKEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:DENISE
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1225 SATARA AVE NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2808
Mailing Address - Country:US
Mailing Address - Phone:503-385-5672
Mailing Address - Fax:
Practice Address - Street 1:3000 MARKET ST NE
Practice Address - Street 2:SUITE 530
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1882
Practice Address - Country:US
Practice Address - Phone:503-385-5672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker