Individual
LAURA ECCLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
421 SW OAK ST, PORTLAND, OR 97204-1817
(503) 988-5464
(503) 988-5870
Mailing address
421 SW OAK ST, PORTLAND, OR 97204-1817
(503) 988-5464
(503) 988-5870
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1395
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70227276
—
CO
Enumeration date
03/25/2010
Last updated
11/06/2014
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