Provider Demographics
NPI:1679724298
Name:VAN KLEEK, ERIN VICTORIA SNEDDON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:VICTORIA SNEDDON
Last Name:VAN KLEEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:VICTORIA
Other - Last Name:SNEDDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4855 SW WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3460
Mailing Address - Country:US
Mailing Address - Phone:503-520-4923
Mailing Address - Fax:503-626-4149
Practice Address - Street 1:4855 SW WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3460
Practice Address - Country:US
Practice Address - Phone:503-520-4923
Practice Address - Fax:503-626-4149
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL4145104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL4145OtherOREGON STATE BOARD OF CLINICAL SOCIAL WORKERS