Individual
LACY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3880 SE 8TH AVE, SUITE 270, PORTLAND, OR 97202-3772
(503) 545-6798
Mailing address
8614 N PORTSMOUTH AVE, PORTLAND, OR 97203-5970
(503) 508-5819
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3445
OR
Other
Enumeration date
11/17/2014
Last updated
04/14/2017
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