Individual
LISA H. WALCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
0424 SW PENDLETON ST, PORTLAND, OR 97239-3755
(503) 245-5241
Mailing address
0424 SW PENDLETON ST, PORTLAND, OR 97239-3755
(503) 245-5241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4357
OR
Other
Enumeration date
10/06/2008
Last updated
12/07/2009
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