Individual
AMY KATHRYN DE LA TORRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, CADC I
Contact information
Practice address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Mailing address
6200 SE KING RD, PORTLAND, OR 97222-2891
(503) 546-6377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L11374
OR
Other
Enumeration date
05/21/2014
Last updated
06/12/2023
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