Individual
AVERY SPOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4929 SE HAWTHORNE BLVD APT 306, PORTLAND, OR 97215-3266
(802) 595-5246
Mailing address
4929 SE HAWTHORNE BLVD APT 306, PORTLAND, OR 97215-3266
(802) 595-5246
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
090707
NY
1041C0700X
Clinical Social Worker
L12496
OR
Other
Enumeration date
11/13/2018
Last updated
12/20/2024
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