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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LOUISE ANN BAUSCHARD L2155SR (MSW,LCSW)
(503) 997-8041
Entity
Organization

Contact information

Practice address
254 N 1ST AVE, HILLSBORO, OR 97124-3003
(503) 997-8041
Mailing address
254 N 1ST AVE, HILLSBORO, OR 97124-3003
(503) 997-8041

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
L2155SR
OR

Other

Enumeration date
06/05/2014
Last updated
06/05/2014
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