Individual
EMILY WEIDLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5511 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3367
(503) 517-1895
Mailing address
5511 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3367
(503) 517-1895
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R8229
OR
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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