Individual
LISA STURDIVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
Mailing address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C6175
OR
106H00000X
Marriage & Family Therapist
T2089
OR
Other
Enumeration date
10/17/2020
Last updated
12/20/2024
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