Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0537 | OR |
NPI | 1003052333 |
---|---|
Provider Name | Ms. Claudette Hastie Beahrs |
First Address | Portland, OR 97212-5123 |
Second Address | Portland, OR 97212-5123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2008 |
Last Update Date | 16/12/2008 |