Organization
ALICE HACKER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE HACKER (LCSW)
(503) 395-0029
Entity
Organization
Contact information
Practice address
4936 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6163
(503) 395-0029
Mailing address
14702 SE RHONE ST, PORTLAND, OR 97236-2557
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/24/2023
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