Sandra Ann Tate, LCSW
Social Worker, Clinical in Portland, OR. Individual provider (NPI-1).
NPI number1144909623
StatusActive
Last updated in NPPESJul 12, 2023
Details
- NPI
- 1144909623
- Entity type
- Individual (NPI-1)
- Name
- Ms. Sandra Ann Tate
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 12, 2023
- Certification date
- Jul 12, 2023
- Last updated
- Jul 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | L7459 | OR | Yes |
Practice location
1231 Ne Martin Luther King Jr Blvd Apt 616Portland, OR 97232-2074
Phone 503-830-4429
Mailing address
1231 Ne Martin Luther King Jr Blvd Apt 616Portland, OR 97232-2074
Phone 503-830-4429
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