Individual
MS. LISA ELLEN LEWIS CAVALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6221 NE FREMONT ST, #103, PORTLAND, OR 97213-4437
(503) 577-1385
(503) 772-4776
Mailing address
6221 NE FREMONT ST, #103, PORTLAND, OR 97213-4437
(503) 577-1385
(503) 772-4776
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01814
OR
1041C0700X
Clinical Social Worker
LW00005085
WA
1041C0700X
Clinical Social Worker
PENDING
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01814
LICENSE
OR
Enumeration date
02/19/2007
Last updated
07/08/2007
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