Provider Demographics
NPI:1861374258
Name:CLARK, ADRY SNORRADOTTIR (PHD)
Entity type:Individual
Prefix:
First Name:ADRY
Middle Name:SNORRADOTTIR
Last Name:CLARK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ADRY
Other - Middle Name:S
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SNORRADOTTIR
Mailing Address - Street 1:2130 SE ARROWWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-3406
Mailing Address - Country:US
Mailing Address - Phone:541-908-3705
Mailing Address - Fax:
Practice Address - Street 1:11740 SW 68TH PKWY STE 200
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-9058
Practice Address - Country:US
Practice Address - Phone:541-908-3705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR10273101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor