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1336235126
GERALD ERIC DECKELBAUM
PORTLAND, OR
NPI
1336235126
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR 2999)
Enumeration Date
2006-10-05
Last Update Date
2007-07-08
Business Address
Mr. GERALD ERIC DECKELBAUM LCSW
1020 SW TAYLOR ST #445
PORTLAND, OR 97205-2543
Phone number: 503-224-0033
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Mailing Address
Mr. GERALD ERIC DECKELBAUM LCSW
1137 SE 52ND AVE
PORTLAND, OR 97215-2632
Phone number: 503-232-3761
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