Individual
JULIE BROCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7704 SE 13TH AVE, PORTLAND, OR 97202-6348
(503) 201-1910
Mailing address
P.O. BOX 86321, PORTLAND, OR 97206
(503) 201-1910
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3508
OR
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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