Individual
MRS. ELIZABETH MARY BOGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2225 NE MLK JR BLVD, STE 207, PORTLAND, OR 97212-3727
(971) 284-7313
Mailing address
3406 N WILLIS BLVD, PORTLAND, OR 97217-7264
(971) 284-7313
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C4160
OR
101YM0800X
Mental Health Counselor
CG60460126
WA
101YM0800X
Mental Health Counselor
MC60480487
WA
Other
Enumeration date
06/13/2014
Last updated
07/24/2016
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