Healthcare Provider Details

I. General information

NPI: 1578645883
Provider Name (Legal Business Name): MADELYN ABRAM NAWROCKI LCSW, MSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 09/24/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9670 SW BEAVERTON HILLSDALE HWY
BEAVERTON OR
97005-3307
US

IV. Provider business mailing address

PO BOX 397
RAINIER OR
97048-0397
US

V. Phone/Fax

Practice location:
  • Phone: 593-739-1084
  • Fax:
Mailing address:
  • Phone: 503-739-1084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4451
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: