Organization
GWENN CODY, LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENN CODY-WALD LCSW (PRESIDENT)
(503) 230-0518
Entity
Organization
Contact information
Practice address
819 SE MORRISON ST STE 250, 819 SE MORRISON ST STE 250, PORTLAND, OR 97214-6315
(503) 230-0518
(503) 200-1438
Mailing address
819 SE MORRISON ST STE 250, 819 SE MORRISON ST STE 250, PORTLAND, OR 97214-6315
(503) 230-0518
(503) 200-1438
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
2018
OR
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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