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Individual

MARTHA ANN EARLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2705 E BURNSIDE ST STE 206, PORTLAND, OR 97214-1768
(503) 539-7799
Mailing address
2705 E BURNSIDE ST STE 206, PORTLAND, OR 97214-1768
(503) 539-7799

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
102203
NY
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
07/02/2018
Last updated
11/01/2021
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