Individual
EMILY VAN DER LAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC INTERN
Contact information
Practice address
3519 NE 15TH AVE # 360, PORTLAND, OR 97212-2356
(541) 357-6878
Mailing address
14345 NE KNOTT ST, PORTLAND, OR 97230-3832
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R6313
OR
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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