Individual
MS. GAIA ILENE ARTEMISIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15 N MORRIS ST, PORTLAND, OR 97227-1541
(503) 230-9875
(503) 230-9877
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(971) 386-2278
(503) 224-4494
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4260
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500655607
—
OR
Enumeration date
08/19/2008
Last updated
04/12/2017
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