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NPI Code Detail

MEDICARE: PAUL E SORENSON LCSW

MEDICARE: PAUL E SORENSON 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
11041C0700XClinical Social WorkerL4139OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659517894
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL E SORENSON LCSW
Provider Business Mailing Address
First Line : PO BOX 1114
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-4114
Country : US
Telephone Number : 503-608-8735
Fax Number : 503-608-8735
Provider Business Practice Location Address
First Line : 1909 MOUNTAIN VIEW LN
Second Line : STE 200
City : FOREST GROVE
State : OR
Zip : 97116-2894
Country : US
Telephone Number : 503-608-8735
Fax Number : 503-608-8735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2008
Last Update Date : 11/23/2016

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Directions to “ PAUL E SORENSON LCSW” Practice Location

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