Individual
DIANE E PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9830 NE CASCADES PKWY, SUITE 200, PORTLAND, OR 97220-6832
(503) 239-8101
(503) 239-8106
Mailing address
9830 NE CASCADES PKWY, SUITE 200, PORTLAND, OR 97220-6832
(503) 239-8101
(503) 239-8106
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1294
OR
Other
Enumeration date
09/28/2010
Last updated
05/09/2011
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