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Individual

MR. MICHAEL FREDERICK CHASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2015 NE 39TH AVE, PORTLAND, OR 97212-5305
(503) 475-3527
Mailing address
2104 NE 45TH AVE, PORTLAND, OR 97213-1342
(503) 475-3527

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3286
OR
1041C0700X
Clinical Social Worker
LW00007678
WA

Other

Enumeration date
01/30/2007
Last updated
11/14/2014
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