Provider Demographics
NPI:1326021932
Name:PHILLIPS WERBEL, LYNNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:
Last Name:PHILLIPS WERBEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16110 SW REGATTA LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8942
Mailing Address - Country:US
Mailing Address - Phone:503-690-9119
Mailing Address - Fax:503-617-9379
Practice Address - Street 1:16110 SW REGATTA LN
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8942
Practice Address - Country:US
Practice Address - Phone:503-690-9119
Practice Address - Fax:503-617-9379
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLCSW407104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR107915Medicare ID - Type Unspecified
P15843Medicare UPIN