Individual
ELISA BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7632 SE FLAVEL ST, PORTLAND, OR 97206-7813
(503) 467-0581
Mailing address
7632 SE FLAVEL ST, PORTLAND, OR 97206-7813
(503) 467-0581
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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