Individual
MRS. MARIEKA CAITLIN FARRENKOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDM, LCSW
Contact information
Practice address
2256 NW PETTYGROVE ST, PORTLAND, OR 97210-2608
(503) 710-4236
Mailing address
2256 NW PETTYGROVE ST, PORTLAND, OR 97210-2608
(503) 710-4236
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3588
OR
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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