Provider Demographics
NPI:1679374771
Name:BALKEMA, ANNA LEE (MSW, CSWA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE
Last Name:BALKEMA
Suffix:
Gender:
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 SW LEVENS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-3228
Mailing Address - Country:US
Mailing Address - Phone:541-730-0293
Mailing Address - Fax:
Practice Address - Street 1:1557 SW LEVENS ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-3228
Practice Address - Country:US
Practice Address - Phone:541-730-0293
Practice Address - Fax:541-730-0293
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA143281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical