Most Relevant Information
Provider Data
| NPI Number: | 1003373101 |
| Provider Name: | CARLA E FADRIQUELA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCSW-4328 |
Most Important Dates
| Enumeration Date: | 02/25/2019 |
| Last Updated: | 02/25/2019 |
Provider Practice Location
2980 SW 123RD AVE
BEAVERTON
OR
970051325
Practice Location Phone/Fax
| Phone: | 8082814616 |
| Fax: |
Provider Mailing Location
2980 SW 123RD AVE
BEAVERTON
OR
970051325
Provider Mailing Phone/Fax
| Phone: | 8082814616 |
| Fax: |