Individual
JUSTIN C O'HANLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2100 SE LAKE RD, #2A, MILWAUKIE, OR 97222-7759
(503) 753-4559
(503) 387-3027
Mailing address
2100 SE LAKE RD, #2A, MILWAUKIE, OR 97222-7759
(503) 753-4559
(503) 387-3027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3787
OR
Other
Enumeration date
12/22/2006
Last updated
06/21/2011
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