Individual
TAMARA L BAKEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
0125 SW VERMONT ST, PORTLAND, OR 97219-2321
(951) 236-4638
Mailing address
PO BOX 82183, PORTLAND, OR 97282-0183
(951) 236-4638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041S0200X
School Social Worker
—
—
Other
Enumeration date
11/22/2010
Last updated
03/17/2011
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