Individual
ALYSSA K PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5151 SE HOLGATE BLVD APT 204, PORTLAND, OR 97206-3887
(972) 567-4084
Mailing address
5151 SE HOLGATE BLVD APT 204, PORTLAND, OR 97206-3887
(972) 567-4084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L8171
OR
Other
Enumeration date
12/31/2021
Last updated
12/31/2021
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