Individual
EMILY MARIE KETOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9775 SE SUNNYSIDE RD STE 200, CLACKAMAS, OR 97015-5721
(503) 794-3830
(503) 794-3850
Mailing address
2051 KAEN RD, SUITE 367, OREGON CITY, OR 97045-4035
(503) 742-5300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5681
OR
Other
Enumeration date
10/14/2009
Last updated
03/25/2013
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