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General NPI Number Information
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NPI Number | 1336547785
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Entity Type | Individual
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Provider Name | DEBRAH LEE LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 09/20/2017
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Provider Practice Location Address
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Address Line | 1200 NW 23RD AVE
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City | PORTLAND
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State | OR
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Zip | 97210-2906
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Country | US
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Telephone | 503-413-7074
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3808
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City | PORTLAND
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State | OR
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Zip | 97208-3808
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Country | US
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Telephone | 503-413-3900
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Fax | 503-413-3710
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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 | L7351
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License Number State | OR
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