Individual
MRS. CARMEN LACEY CALVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 SW MARLOW AVE STE 315, PORTLAND, OR 97225-5105
(503) 709-5137
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/14/2014
Last updated
01/05/2022
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