Provider Demographics
NPI:1083812796
Name:O'HANLON, PATTI MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:MARIE
Last Name:O'HANLON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14465 SE HILLGROVE CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-1528
Mailing Address - Country:US
Mailing Address - Phone:503-736-6527
Mailing Address - Fax:503-256-9601
Practice Address - Street 1:11456 NE KNOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-1706
Practice Address - Country:US
Practice Address - Phone:503-736-6527
Practice Address - Fax:503-256-9601
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker