Individual
AMANDA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MSW, LCSW
Contact information
Practice address
700 SW CAMPUS DR, PORTLAND, OR 97239-3107
(503) 494-9218
Mailing address
10033 SW 25TH AVE, PORTLAND, OR 97219-6324
(928) 486-1523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11817
OR
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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