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Individual

MS. LAURA BURKE IVERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
104 NE BRYANT ST, PORTLAND, OR 97211-2304
(503) 673-6072
Mailing address
104 NE BRYANT ST, PORTLAND, OR 97211-2304
(503) 673-6072

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6469
OR

Other

Enumeration date
09/06/2022
Last updated
09/06/2022
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