Individual
BRENDA IMOGEN WIERSCHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L004393
—
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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