Provider Demographics
NPI:1124446752
Name:CALLAHAN, LORENE MARIE (MSW)
Entity type:Individual
Prefix:MS
First Name:LORENE
Middle Name:MARIE
Last Name:CALLAHAN
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 1:1244 NE HACIENDA LN
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-4634
Mailing Address - Country:US
Mailing Address - Phone:503-544-3547
Mailing Address - Fax:
Practice Address - Street 1:4134 N VANCOUVER AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2900
Practice Address - Country:US
Practice Address - Phone:503-331-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical