Healthcare Provider Details

I. General information

NPI: 1114131604
Provider Name (Legal Business Name): KAREN MAIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14255 SW BRIGADOON CT
BEAVERTON OR
97005-3369
US

IV. Provider business mailing address

1004 NE GALLOWAY ST
MCMINNVILLE OR
97128-3833
US

V. Phone/Fax

Practice location:
  • Phone: 503-641-1475
  • Fax:
Mailing address:
  • Phone: 503-434-6509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4001
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: