Individual
MISS HALLIE HAVICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1110 SE ALDER ST # 310, PORTLAND, OR 97214-2400
(503) 847-9950
Mailing address
PO BOX 86953, PORTLAND, OR 97286-0953
(503) 847-9950
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW-68709
CA
Other
Enumeration date
12/09/2013
Last updated
08/04/2019
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