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Individual

MS. JEAN LOUISE WATERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
605 SE 39TH AVE, PORTLAND, OR 97214-3216
(503) 231-7480
(503) 731-9574
Mailing address
7805 SW TAYLORS FERRY RD, PORTLAND, OR 97223-9072
(503) 244-3509

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1272
OR

Other

Enumeration date
12/19/2007
Last updated
12/19/2007
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