Individual
EVAN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2020 SW 4TH AVE, SUITE 520, PORTLAND, OR 97201-4953
(971) 235-8079
Mailing address
PO BOX 4025, PORTLAND, OR 97208-4025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3705
OR
1041C0700X
Clinical Social Worker
LCS9474
CA
1041C0700X
Clinical Social Worker
LW00008482
WA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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