Healthcare Provider Details

I. General information

NPI: 1578329280
Provider Name (Legal Business Name): MARGARET GRAEBER-SIMON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13110 SE SUNNYSIDE RD STE B
CLACKAMAS OR
97015-8468
US

IV. Provider business mailing address

2220 SE 72ND AVE
PORTLAND OR
97215-4048
US

V. Phone/Fax

Practice location:
  • Phone: 503-659-3480
  • Fax:
Mailing address:
  • Phone: 215-901-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: