Individual
DARCELL DANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5329 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3237
(503) 988-5183
(503) 988-5182
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-3663
(503) 988-4098
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3553
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
05
—
093511
—
OR
Enumeration date
01/26/2011
Last updated
01/26/2011
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