Individual
HEATHER SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(503) 894-1871
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6080
OR
Other
Enumeration date
05/09/2014
Last updated
05/09/2014
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