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Individual

JENNIFER L SHAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2045 SE HAWTHORNE BLVD, PORTLAND, OR 97214-3819
(503) 866-9025
Mailing address
4110 SE HAWTHORNE BLVD, 750, PORTLAND, OR 97214-5246
(503) 866-9025

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4645
OR

Other

Enumeration date
07/18/2011
Last updated
07/18/2011
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