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Organization

CHANGING PERCEPTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVONNA LIVINGSTON (FOUNDER)
(502) 290-4513
Entity
Organization

Contact information

Practice address
522 SW 13TH AVE, PORTLAND, OR 97205-2307
(503) 290-4513
Mailing address
PO BOX 2071, PORTLAND, OR 97208-2071
(503) 290-4513

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104100000X
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500671954
OR
Enumeration date
08/19/2014
Last updated
08/19/2014
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