Individual
MS. DANETTE CHARISSE GILLESPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
215 NE 60TH AVE, PORTLAND, OR 97213-3721
(503) 482-8982
(503) 914-1755
Mailing address
215 NE 60TH AVE, PORTLAND, OR 97213-3721
(503) 482-8982
(503) 914-1755
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4020
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673411
—
OR
Enumeration date
03/19/2007
Last updated
05/08/2026
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