Individual
SHEREEN HULLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3415 SE POWELL BLVD., PORTLAND, OR 97202
(503) 234-9591
Mailing address
3415 SE POWELL BLVD., PORTLAND, OR 97202
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6099
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500670719
—
OR
Enumeration date
04/18/2014
Last updated
12/10/2014
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