Individual
LAUREN MARY MACNEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3310 SE DIVISION ST, PORTLAND, OR 97202-1457
(503) 380-8528
Mailing address
2223 SE 54TH AVE, PORTLAND, OR 97215-3921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4167
OR
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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