Individual
ONAMPAI MODI SOONDAROTOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2000 NE 42ND AVE # 1004, PORTLAND, OR 97213-1399
(503) 683-1558
Mailing address
2000 NE 42ND AVE # 1004, PORTLAND, OR 97213-1399
(503) 683-1558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11071
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/22/2019
Last updated
05/26/2023
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