Individual
MS. CAROLINE BOWLES BLECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L4010
—
OR
Enumeration date
01/11/2007
Last updated
12/07/2015
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