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Individual

LISA PAULINE KNUDSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CADCII

Contact information

Practice address
20512 SW ROY ROGERS RD, SUITE 150, SHERWOOD, OR 97140
(503) 341-2694
Mailing address
20512 SW ROY ROGERS RD, SUITE 150, SHERWOOD, OR 97140-9929
(503) 341-2694

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
03-03-60
OR
101YP2500X
Professional Counselor
Primary
C4979
OR

Other

Enumeration date
12/03/2016
Last updated
09/06/2018
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