Individual
MR. EDWARD THOMAS KEATING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
516 SE MORRISON ST, PORTLAND, OR 97214-2327
(503) 504-9499
Mailing address
3150 NE 22ND AVE, PORTLAND, OR 97212-2425
(503) 504-9499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2951
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2951
BOARD OF CLINICAL SOCIAL WORK
OR
Enumeration date
06/08/2008
Last updated
06/08/2008
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