Individual
CLANCY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N GRAHAM ST STE 375, PORTLAND, OR 97227-2001
(503) 413-1600
(503) 413-1915
Mailing address
PO BOX 4399, PORTLAND, OR 97208-4399
(503) 413-1600
(503) 413-1915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CG60463999
WA
1041C0700X
Clinical Social Worker
Primary
L7391
OR
Other
Enumeration date
05/16/2014
Last updated
05/29/2019
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