Individual
KRISTA RENEE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6207 NE BROADWAY, PORTLAND, OR 97213-4713
(503) 890-0321
Mailing address
6207 NE BROADWAY, PORTLAND, OR 97213-4713
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4803
OR
1041C0700X
Clinical Social Worker
60807178
WA
Other
Enumeration date
05/03/2020
Last updated
05/03/2020
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