Individual
LYDIA LOUISE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CSWA
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
(503) 215-8593
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(503) 215-9800
(503) 215-8593
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A4052
OR
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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