Louis Carl Wackerle MSSW

NPI 1174842512 - Social Worker - 1041C0700X

NPI Details
NPI 1174842512
Gender Male
Enumeration Date 05/25/2010
Last Updated 05/25/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
4805 NE GLISAN
3M16
PORTLAND OR, 97225, US
Phone (503) 295-1804
Fax
Business Location
BOX 408
7327 SW BARNES RD
PORTLAND OR, 97225, US
Phone (503) 295-1804
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Oregon
License Number 0186
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According to our database, Mr. Louis Carl Wackerle MSSW NPI is 1174842512, taxonomy code is 1041C0700X and license number is 0186, license state is located at Oregon. Louis Carl Wackerle MSSW physically located at 4805 Ne Glisan, Portland OR, 97225. NPI Number Louis Carl Wackerle MSSW has the Individual type.

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1174842512 NPI number is provided on an as is basis without warranty of any kind. 1174842512 is maintained by the National Plan & Provider Enumeration System. The contents of Louis Carl Wackerle MSSW are for informational purposes only.