| Tracy Bryce Farmer Lcsw Pc | |
|
1020 Sw Taylor St Suite 435 Portland OR 97205-2543 | |
| (503) 841-2722 | |
| (541) 668-8013 |
| Full Name | Tracy Bryce Farmer Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1020 Sw Taylor St, Portland, Oregon |
| Authorized Official Name and Position | Tracy Bryce Farmer (PRESIDENT) |
| Authorized Official Contact | 5034513267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Bryce Farmer Lcsw Pc 1020 Sw Taylor St Suite 435 Portland OR 97205-2543 Ph: (503) 841-2722 | Tracy Bryce Farmer Lcsw Pc 1020 Sw Taylor St Suite 435 Portland OR 97205-2543 Ph: (503) 841-2722 |
| NPI Number | 1588052393 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 09/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588052393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 5679 (Oregon) | Primary |
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