Individual
SARA PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4708 SE 65TH AVE, PORTLAND, OR 97206-4652
(503) 320-8753
Mailing address
4708 SE 65TH AVE, PORTLAND, OR 97206-4652
(503) 320-8753
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L4006
OR
104100000X
Social Worker
—
—
Other
Enumeration date
02/21/2007
Last updated
03/09/2023
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