Individual
HOLLY KOEHMSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
537 SE ALDER ST, PORTLAND, OR 97214-2231
(503) 595-3477
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M5503
OR
1041C0700X
Clinical Social Worker
Primary
A5503
OR
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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