Individual
ALLISON WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, MDIV, QMHP
Contact information
Practice address
3034 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3053
(503) 283-3763
Mailing address
3034 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3053
(503) 283-3763
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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