Individual
PHOENIX MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3050 SE DIVISION ST STE 205, PORTLAND, OR 97202-1997
(971) 808-2115
Mailing address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/13/2007
Last updated
05/22/2023
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