Individual
JACQUELINE ELIZABETH BOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1831 SE 7TH AVE STE 201, PORTLAND, OR 97214-3580
(503) 912-4930
Mailing address
3385 SE FRANCIS ST, PORTLAND, OR 97202-3053
(720) 563-1321
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11479
OR
Other
Enumeration date
12/31/2019
Last updated
06/05/2025
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