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1174842512
LOUIS CARL WACKERLE
PORTLAND, OR
NPI
1174842512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR 0186)
Enumeration Date
2010-05-25
Last Update Date
2010-05-25
Business Address
Mr. LOUIS CARL WACKERLE MSSW
4805 NE GLISAN 3M16
PORTLAND, OR 97225
Phone number: 503-295-1804
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Mailing Address
Mr. LOUIS CARL WACKERLE MSSW
BOX 408 7327 SW BARNES RD
PORTLAND, OR 97225
Phone number: 503-295-1804
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