Individual
LOTUS TEEGARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1940 NE BROADWAY ST, PORTLAND, OR 97232-1502
(971) 415-6344
(503) 388-3397
Mailing address
1940 NE BROADWAY ST, PORTLAND, OR 97232-1502
(971) 415-6344
(503) 388-3397
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L11823
OR
Other
Enumeration date
07/16/2015
Last updated
06/23/2025
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