Individual
OLIVIA L PENNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CWSA
Contact information
Practice address
959 SE DIVISION ST STE 520, PORTLAND, OR 97214-4672
(503) 549-4714
Mailing address
PO BOX 90309, PORTLAND, OR 97290-0309
(503) 549-4714
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A14227
OR
Other
Enumeration date
10/18/2023
Last updated
08/27/2024
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