Individual
RACHEL PETKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2800 N VANCOUVER AVE STE 207, PORTLAND, OR 97227-1630
(503) 276-9000
(503) 276-9010
Mailing address
PO BOX 4037, PORTLAND, OR 97208-4037
(503) 413-4048
(503) 413-2910
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3240
OR
1041C0700X
Clinical Social Worker
Primary
L3240
OR
Other
Enumeration date
09/19/2019
Last updated
01/24/2020
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