Provider Demographics
NPI:1609025667
Name:SALVEY-SUNDE, PATTY SUE (MSW , LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:SUE
Last Name:SALVEY-SUNDE
Suffix:
Gender:F
Credentials:MSW , LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 NW VAUGHN ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5311
Mailing Address - Country:US
Mailing Address - Phone:503-721-4906
Mailing Address - Fax:503-499-5777
Practice Address - Street 1:2701 NW VAUGHN ST
Practice Address - Street 2:SUITE 160
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5311
Practice Address - Country:US
Practice Address - Phone:503-721-4906
Practice Address - Fax:503-499-5777
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL14821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL1482OtherLICENSED CLINICAL SOCIAL WORKER