Individual
MABEL VAUTRAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3800
Mailing address
7619 SE HAROLD ST # 97206, PORTLAND, OR 97206-5233
(971) 533-2962
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/02/2022
Last updated
07/02/2022
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