Individual
MICHELLE MITSUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2109 WEMBLEY PARK RD, LAKE OSWEGO, OR 97034-2617
(310) 210-1697
Mailing address
PO BOX 332, LAKE OSWEGO, OR 97034-0040
(310) 210-1697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6725
OR
1041C0700X
Clinical Social Worker
LCS23428
CA
Other
Enumeration date
09/07/2008
Last updated
12/09/2015
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