MEDICARE: VERONICA LIM LCSW, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	23501	CA
2	1041C0700X	Clinical Social Worker	L5213	OR

General Provider Information

NPI Number	:	1144980491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA LIM LCSW, MPH

Provider Business Mailing Address
First Line	:	333 S STATE ST STE V-236
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 MEADOWS RD STE 326
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-4264
Country	:	US
Telephone Number	:	503-664-4927
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	12/28/2021

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