Individual
BRENDA L WILMARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
4423 NE TILLAMOOK ST, PORTLAND, OR 97213-1317
(503) 704-4115
Mailing address
4805 NE DAVIS ST, PORTLAND, OR 97213-2917
(503) 239-4453
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3944
OR
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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