Individual
LACIE BAUMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8383 NE SANDY BLVD STE 205, PORTLAND, OR 97220-4967
(503) 253-0964
(503) 253-7659
Mailing address
8383 NE SANDY BLVD STE 205, PORTLAND, OR 97220-4967
(503) 253-0964
(503) 253-7659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R7575
OR
101YP2500X
Professional Counselor
Primary
C9301
OR
Other
Enumeration date
07/06/2022
Last updated
02/03/2025
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