Individual
AIMEE AMODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
14523 SE GLADSTONE ST, PORTLAND, OR 97236-2491
(360) 836-0725
Mailing address
14523 SE GLADSTONE ST, PORTLAND, OR 97236-2491
(360) 836-0725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A4961
OR BOARD OF LICENSED SOCIAL WORKERS
OR
01
—
LW61091991
WA DEPT OF HEALTH
WA
Enumeration date
06/18/2017
Last updated
08/05/2022
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