Provider Demographics
NPI:1750447702
Name:MASOVER, EILEEN (MSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:MASOVER
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 1:22366 SE RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-8306
Mailing Address - Country:US
Mailing Address - Phone:971-444-2944
Mailing Address - Fax:
Practice Address - Street 1:2816 SE HARRISON ST
Practice Address - Street 2:STE 305
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7536
Practice Address - Country:US
Practice Address - Phone:971-444-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL40691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical