Individual
LISA CATHERINE KNISELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LICSWA
Contact information
Practice address
863 NE SIMPSON ST, PORTLAND, OR 97211-3748
(520) 668-0800
Mailing address
863 NE SIMPSON ST, PORTLAND, OR 97211-3748
(520) 668-0800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
A12614
OR
1041C0700X
Clinical Social Worker
Primary
SC61304006
WA
Other
Enumeration date
08/03/2021
Last updated
09/21/2022
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