Individual
CAROL LYNN NIGHTENGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PC
Contact information
Practice address
320 N MAIN AVE, SUITE 216, GRESHAM, OR 97030-7242
(503) 669-1095
(503) 665-3299
Mailing address
320 N MAIN AVE, SUITE 216, GRESHAM, OR 97030-7242
(503) 669-1095
(503) 665-3299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
592
OR
Other
Enumeration date
10/17/2006
Last updated
04/19/2012
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