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General NPI Number Information
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NPI Number | 1649661331
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Entity Type | Individual
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Provider Name | NICHOLAS VERDEGAN WARD MSW, CSWA, CADC I,
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Gender | Male
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 720 SE WASHINGTON ST.
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City | HILLSBORO
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State | OR
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Zip | 97123
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Country | US
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Telephone | 503-648-0753
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Fax | 503-648-0755
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Provider Business Mailing Address
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Address Line | 1027 E. BURNSIDE ST.
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 503-239-8400
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Fax | 503-269-8407
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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 | A3862
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License Number State | OR
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