Individual
KENNETH J DONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, MS
Contact information
Practice address
12100 NW LOVEJOY ST, PORTLAND, OR 97229-4928
(503) 680-6478
Mailing address
12100 NW LOVEJOY ST, PORTLAND, OR 97229-4928
(503) 680-6478
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L1513
OR
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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