Individual
MS. GIA MICHELE BUCKBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1722 NW RALEIGH ST SPC 418, PORTLAND, OR 97209-1754
(503) 272-1069
Mailing address
2701 SW BOUNDARY ST, PORTLAND, OR 97239-7101
(503) 913-7826
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6820
OR
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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