Individual
MS. REBECCA WITHEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15220 NW LAIDLAW RD STE 102, PORTLAND, OR 97229-7717
(503) 418-2402
Mailing address
15220 NW LAIDLAW RD STE 102, PORTLAND, OR 97229-7717
(503) 418-2000
(503) 494-6968
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
A2642
OR
1041C0700X
Clinical Social Worker
Primary
L5344
OR
Other
Enumeration date
03/07/2011
Last updated
10/09/2017
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