Organization
SUSAN B MERRICK, LCSW, DCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN BLANCHARD MERRICK LCSW (OWNER)
(503) 781-3403
Entity
Organization
Contact information
Practice address
510 SW 3RD AVE, SUITE 200, PORTLAND, OR 97204-2543
(503) 781-3403
Mailing address
PO BOX 86706, PORTLAND, OR 97286-0706
(503) 781-3403
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
L6896
OR
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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