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Individual

COLETTE RENEE DELEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1217 NE BURNSIDE RD, BUILDING B SUITE 401, GRESHAM, OR 97030-6722
(503) 666-8832
(503) 669-8641
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
(503) 233-2696

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3792
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164936
OR
Enumeration date
02/16/2007
Last updated
07/09/2007
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