Individual
NICOLE RENEE GERRITSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
200 SE 7TH AVE, PORTLAND, OR 97214-1200
(503) 235-0131
Mailing address
200 SE 7TH AVE, PORTLAND, OR 97214-1200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10336
OR
Other
Enumeration date
10/27/2017
Last updated
10/27/2020
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