Provider Demographics
NPI:1174970628
Name:KRUEGER-TOSCHER, JORDANA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JORDANA
Middle Name:
Last Name:KRUEGER-TOSCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N MAIN AVE
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7242
Mailing Address - Country:US
Mailing Address - Phone:971-270-0741
Mailing Address - Fax:757-257-7460
Practice Address - Street 1:320 N MAIN AVE
Practice Address - Street 2:SUITE 201B
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7242
Practice Address - Country:US
Practice Address - Phone:971-270-0741
Practice Address - Fax:757-257-7460
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-14
Last Update Date:2016-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL66071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical