Individual
NICOLE PANOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 SW 68TH PKWY STE 200, TIGARD, OR 97223-9058
(971) 352-6971
Mailing address
2355 STATE ST, SALEM, OR 97301-4541
(971) 678-7031
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A15477
OR
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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