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Individual

MARK LAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, CADC I

Contact information

Practice address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 736-6571
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 736-6571

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-03-21
OR
101YM0800X
Mental Health Counselor
L6021
OR

Other

Enumeration date
06/12/2008
Last updated
07/14/2021
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