Individual
MR. MICHAEL P BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2367 STATE ST, SUITE 100, SALEM, OR 97301-4541
(503) 540-3442
(503) 540-4097
Mailing address
2367 STATE ST, SUITE 100, SALEM, OR 97301-4541
(503) 540-3442
(503) 540-4097
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
717
OR
Other
Enumeration date
04/05/2006
Last updated
12/21/2016
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