Individual
MR. ROLANDO VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW,LCSW
Contact information
Practice address
12636 SE STARK ST BLDG J, PORTLAND, OR 97233-1058
(319) 321-2115
(503) 253-4609
Mailing address
12636 SE STARK ST BLDG J, PORTLAND, OR 97233-1058
(319) 321-2115
(503) 253-4609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L8488
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L8488
STATE LICENSE
OR
Enumeration date
12/16/2006
Last updated
06/23/2021
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