Individual
MS. EMILY ELIZABETH LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5741 NE GLISAN ST STE 2, PORTLAND, OR 97213-3793
(360) 608-5360
Mailing address
5741 NE GLISAN ST STE 2, PORTLAND, OR 97213-3793
(360) 608-5360
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C5190
OR
101YM0800X
Mental Health Counselor
CG60613583
WA
Other
Enumeration date
11/11/2015
Last updated
08/10/2022
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