Provider Demographics
NPI:1215266101
Name:PASQUESI, MARY CATHERINE (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY CATHERINE
Middle Name:
Last Name:PASQUESI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-5522
Mailing Address - Country:US
Mailing Address - Phone:503-287-0456
Mailing Address - Fax:
Practice Address - Street 1:3550 N INTERSTATE AVE
Practice Address - Street 2:INTERSTATE MEDICAL OFFICE EAST
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1196
Practice Address - Country:US
Practice Address - Phone:503-331-5213
Practice Address - Fax:503-331-5044
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker