| Konrad Von Walther Lcsw Llc | |
|
443 Ne Knott St Portland OR 97212-3108 | |
| (971) 645-9810 | |
| Not Available |
| Full Name | Konrad Von Walther Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 443 Ne Knott St, Portland, Oregon |
| Authorized Official Name and Position | Konrad A Von Walther (OWNER) |
| Authorized Official Contact | 5039859640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Konrad Von Walther Lcsw Llc 443 Ne Knott St Portland OR 97212 Ph: (503) 985-9640 | Konrad Von Walther Lcsw Llc 443 Ne Knott St Portland OR 97212-3108 Ph: (971) 645-9810 |
| NPI Number | 1255872032 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 03/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255872032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16-02-15 (Oregon) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6961 (Oregon) | Primary |
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