Provider Demographics
NPI:1457126708
Name:TROVILLION, RENEE LYNN (CSWA, MSW)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:TROVILLION
Suffix:
Gender:F
Credentials:CSWA, MSW
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1414 SE SHERRETT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-7134
Mailing Address - Country:US
Mailing Address - Phone:973-271-0690
Mailing Address - Fax:
Practice Address - Street 1:8083 SE 13TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6668
Practice Address - Country:US
Practice Address - Phone:503-995-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical