Individual
MS. AMANDA RAE SOARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, CSWA
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 239-8101
Mailing address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A2507
OR
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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