Individual
ELLEN KACIE LUZAICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
6405 N MARYLAND AVE, PORTLAND, OR 97217-4843
(503) 332-3785
Mailing address
6405 N MARYLAND AVE, PORTLAND, OR 97217-4843
(503) 332-3785
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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