Individual
LISA MARIE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12018 SE OAK ST, PORTLAND, OR 97216-3746
(503) 490-3762
Mailing address
12018 SE OAK ST, PORTLAND, OR 97216-3746
(503) 490-3762
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11530
OR
372600000X
Adult Companion
—
—
Other
Enumeration date
06/04/2012
Last updated
12/19/2023
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