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Individual

ELLEN SCOTT BALTUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6415 SE 18TH AVE, PORTLAND, OR 97202-5525
(503) 490-7353
Mailing address
6415 SE 18TH AVE, PORTLAND, OR 97202-5525
(503) 490-7353

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3968
OR

Other

Enumeration date
07/29/2011
Last updated
07/29/2011
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