Individual
CAROL VIRGILLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5228 NE HOYT ST, BUILDING B, PORTLAND, OR 97213-3055
(503) 215-6474
(503) 215-6477
Mailing address
5228 NE HOYT ST, BUILDING B, PORTLAND, OR 97213-3055
(503) 215-6474
(503) 215-6477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2306
OR
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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