Organization
LAURA MARIE SEPARA THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MARIE SEPARA (MA, LPC)
(503) 724-0943
Entity
Organization
Contact information
Practice address
610 SW ALDER ST, SUITE 1100, PORTLAND, OR 97205-3625
(503) 724-0943
Mailing address
199 NE IRONCREEK TER, HILLSBORO, OR 97124-5150
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C4399
OR
Other
Enumeration date
02/14/2017
Last updated
02/22/2017
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