Individual
LORETTA SEIBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
15994 KEASEY RD, VERNONIA, OR 97064-9437
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
MI
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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