Individual
JOHN PANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
205 NE 50TH AVE, PORTLAND, OR 97213-2909
(503) 215-2678
(503) 215-2688
Mailing address
PO BOX 3395, PORTLAND, OR 97208-3395
(503) 215-4300
(503) 215-0340
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
775
OR
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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