Organization
SHEARWATER COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA FADRIQUELA LCSW (OWNER)
(971) 351-0485
Entity
Organization
Contact information
Practice address
510 SW 3RD AVE STE 200, PORTLAND, OR 97204-2507
(808) 281-4616
(937) 544-4009
Mailing address
2980 SW 123RD AVE, BEAVERTON, OR 97005-1325
(808) 281-4616
(937) 544-4009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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