| Mary Anne Stowell Lcsw, Pc | |
|
4511 Se Hawthorne Blvd Suite 114 Portland OR 97215-3170 | |
| (503) 232-6868 | |
| (503) 253-1285 |
| Full Name | Mary Anne Stowell Lcsw, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4511 Se Hawthorne Blvd, Portland, Oregon |
| Authorized Official Name and Position | Mary Anne Stowell (CEO) |
| Authorized Official Contact | 5034081759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Anne Stowell Lcsw, Pc 4511 Se Hawthorne Blvd Suite 114 Portland OR 97215-3170 Ph: (503) 232-6868 | Mary Anne Stowell Lcsw, Pc 4511 Se Hawthorne Blvd Suite 114 Portland OR 97215-3170 Ph: (503) 232-6868 |
| NPI Number | 1326159773 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 10/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326159773 | NPI | - | NPPES |
| 0001095800 | Other | MHN | |
| 7299505 | Other | AETNA | |
| 825404000 | Other | OR | REGENCE BLUE CROSS |
| 182996 | Medicaid | OR | |
| 330833000001 | Other | PROVIDENCE HEALTH PLAN | |
| 475273 | Other | HTH WORLD WIDE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L2934 (Oregon) | Primary |
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