Individual
DIANE ELIZABETH BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
619 SW 6TH AVE., 5TH FLOOR, PORTLAND, OR 97209
(503) 988-7468
Mailing address
619 SW 6TH AVE., 5TH FLOOR, PORTLAND, OR 97209
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3703
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099293
—
OR
Enumeration date
12/13/2022
Last updated
12/13/2022
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