Individual
CORYNA KERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
912 SW TOMAHAWK PL, DUNDEE, OR 97115-9713
(503) 332-6275
Mailing address
PO BOX 425, DUNDEE, OR 97115-0425
(503) 332-6275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3638
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7482401
DRIVERS LICENSE
OR
Enumeration date
05/20/2020
Last updated
11/27/2023
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