Individual
JACKLYN AMBERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1815 SW MARLOW AVE STE 218, PORTLAND, OR 97225-5187
(503) 444-4862
Mailing address
4722 SW BUDDINGTON ST, PORTLAND, OR 97219-7315
(503) 956-0087
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10360
OR
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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