Organization
LL GONCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEE GONCE LCSW (PRESIDENT)
(503) 704-3064
Entity
Organization
Contact information
Practice address
1318 NW 20TH AVE # A-1, PORTLAND, OR 97209-1671
(503) 704-3064
(503) 961-7703
Mailing address
1736 N WILLAMETTE BLVD, PORTLAND, OR 97217-4415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2426
OR
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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