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General NPI Number Information
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NPI Number | 1124017199
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Entity Type | Individual
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Provider Name | KAREN ST CLAIR LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 2625 SE HAWTHORNE BLVD SUITE H
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City | PORTLAND
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State | OR
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Zip | 97214-2941
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Country | US
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Telephone | 503-407-0421
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Fax | 503-235-5396
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Provider Business Mailing Address
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Address Line | PO BOX 42463
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City | PORTLAND
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State | OR
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Zip | 97242-0463
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Country | US
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Telephone | 503-407-0421
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Fax | 503-235-5396
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L2197
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License Number State | OR
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