Individual
MRS. ELIZABETH SHANNON WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
998 LIBRARY CT, OREGON CITY, OR 97045
(503) 655-8278
Mailing address
998 LIBRARY CT, OREGON CITY, OR 97045-4041
(503) 655-8278
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13-09-62C
OR
101YM0800X
Mental Health Counselor
Primary
C4713
OR
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/27/2010
Last updated
07/17/2018
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