Individual
ELIZABETH VAN WORMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10490 SW EASTRIDGE ST, SUITE 120, PORTLAND, OR 97225-5030
(503) 297-3803
Mailing address
10490 S W EASTRIDGE, SUITE 120, PORTLAND, OR 97225
(503) 297-3803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000814
OR
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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