MEDICARE: CHRISTI DOUD LCSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1558863175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTI DOUD LCSW

Provider Business Mailing Address
First Line	:	2410 SE 10TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-4624
Country	:	US
Telephone Number	:	503-383-9643
Fax Number	:	503-214-5545

Provider Business Practice Location Address
First Line	:	711 SE ANKENY ST STE B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1215
Country	:	US
Telephone Number	:	503-383-9643
Fax Number	:	503-214-5545

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

Provider Enumeration Date	:	02/28/2018
Last Update Date	:	02/25/2026

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Directions to “ CHRISTI DOUD LCSW” Practice Location

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