Individual
JIM HLAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3034 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3053
(503) 998-3406
Mailing address
PO BOX 9275, PORTLAND, OR 97207-9275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1161
OR
Other
Enumeration date
02/28/2007
Last updated
04/17/2008
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