Individual
LISA WALDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3900 SW MURRAY BLVD, BEAVERTON, OR 97005-2454
(503) 644-2545
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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