Organization
GREAT BLUE HERON COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN LUTZ MSW, LCSW (CLINICAL SOCIAL WORKER)
(503) 400-3265
Entity
Organization
Contact information
Practice address
4223 SE 66TH AVE, PORTLAND, OR 97206-3658
(503) 400-3265
Mailing address
4223 SE 66TH AVE, PORTLAND, OR 97206-3658
(503) 400-3265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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