Individual
EILEEN BRADLEY SUMMIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
637 N FARRAGUT ST, PORTLAND, OR 97217-1473
(503) 358-5130
Mailing address
637 N FARRAGUT ST, PORTLAND, OR 97217-1473
(503) 358-5130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1995
OR
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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