Individual
MARK VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
33 NW BROADWAY, PORTLAND, OR 97209-3580
(503) 228-7134
(503) 445-0749
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4625
OR
Other
Enumeration date
10/26/2010
Last updated
04/20/2012
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