Individual
MARY MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5305 RIVER RD N STE B, KEIZER, OR 97303-5324
(503) 389-5360
Mailing address
PO BOX 14282, PORTLAND, OR 97293-0282
(503) 389-5360
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L12206
OR
Other
Enumeration date
06/17/2014
Last updated
10/08/2021
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