Individual
BETTINA BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(612) 834-0116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A15454
OR
1041S0200X
School Social Worker
549944
OR
Other
Enumeration date
09/23/2014
Last updated
09/06/2024
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