| Soma | |
|
833 Sw 11th Ave Suite 320 Portland OR 97205-2125 | |
| (503) 227-5692 | |
| (506) 227-8183 |
| Full Name | Soma |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 833 Sw 11th Ave, Portland, Oregon |
| Authorized Official Name and Position | Beverly Lois Schwartz (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5032275692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soma 833 Sw 11th Ave Suite 320 Portland OR 97205-2125 Ph: (503) 227-5692 | Soma 833 Sw 11th Ave Suite 320 Portland OR 97205-2125 Ph: (503) 227-5692 |
| NPI Number | 1194084830 |
|---|---|
| Provider Enumeration Date | 05/15/2012 |
| Last Update Date | 05/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194084830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L2048 (Oregon) | Primary |
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