Individual
AVERY BILL-POVIDAILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSWA
Contact information
Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3907
Mailing address
16721 SE WOODWARD ST, PORTLAND, OR 97236-1435
(503) 719-1569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A4030
OR
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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