Individual
DALE KERECZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(503) 929-4945
Mailing address
7480 SW 49TH CT, PORTLAND, OR 97219-1492
(503) 929-4945
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5516
OR
Other
Enumeration date
10/10/2014
Last updated
08/28/2019
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