Organization
ANDREA MIZE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA L MIZE L.C.S.W. (OWNER)
(503) 957-5947
Entity
Organization
Contact information
Practice address
10175 SW BARBUR BLVD STE 300BG, PORTLAND, OR 97219-5909
(503) 957-5947
(503) 206-0926
Mailing address
3 MONROE PKWY, STE P 242, LAKE OSWEGO, OR 97035-1486
(503) 957-5947
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7328
OR
Other
Enumeration date
04/20/2017
Last updated
01/02/2019
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