Individual
KAREN ST CLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2625 SE HAWTHORNE BLVD, SUITE H, PORTLAND, OR 97214-2941
(503) 407-0421
(503) 235-5396
Mailing address
PO BOX 42463, PORTLAND, OR 97242-0463
(503) 407-0421
(503) 235-5396
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2197
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500604645
—
OR
01
—
R148851
MEDICARE PTAN
OR
Enumeration date
10/20/2005
Last updated
04/23/2010
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