Individual
MS. SHARNISSA SECRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4110 NE 122ND AVE STE 115, PORTLAND, OR 97230-1384
(503) 756-3997
Mailing address
10940 SE LONG ST, PORTLAND, OR 97266-3449
(503) 756-3997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6941
OR
Other
Enumeration date
07/05/2016
Last updated
09/12/2023
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