Provider Demographics
NPI:1346611449
Name:GASCON, EMALEE CAFFREY (LCSW)
Entity Type:Individual
Prefix:
First Name:EMALEE
Middle Name:CAFFREY
Last Name:GASCON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMA-LEE
Other - Middle Name:GENE
Other - Last Name:CAFFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AAC
Mailing Address - Street 1:7650 SW BEVELAND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8692
Mailing Address - Country:US
Mailing Address - Phone:503-601-3615
Mailing Address - Fax:503-646-1683
Practice Address - Street 1:9701 SW BARNES RD STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6689
Practice Address - Country:US
Practice Address - Phone:503-734-3700
Practice Address - Fax:503-473-8462
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL116381041C0700X
WACG60578626101Y00000X
WALW614943141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor