| Susan B Merrick, Lcsw, Dcsw, Llc | |
|
510 Sw 3rd Ave Suite 200 Portland OR 97204-2543 | |
| (503) 781-3403 | |
| Not Available |
| Full Name | Susan B Merrick, Lcsw, Dcsw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 510 Sw 3rd Ave, Portland, Oregon |
| Authorized Official Name and Position | Susan Blanchard Merrick (OWNER) |
| Authorized Official Contact | 5037813403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan B Merrick, Lcsw, Dcsw, Llc Po Box 86706 Portland OR 97286-0706 Ph: (503) 781-3403 | Susan B Merrick, Lcsw, Dcsw, Llc 510 Sw 3rd Ave Suite 200 Portland OR 97204-2543 Ph: (503) 781-3403 |
| NPI Number | 1013464809 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 09/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013464809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | L6896 (Oregon) | Primary |
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