Provider Demographics
NPI:1487797197
Name:CULVER, AMBER R (LCSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:CULVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:R
Other - Last Name:BIRLEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3408 SE 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2608
Mailing Address - Country:US
Mailing Address - Phone:360-823-8912
Mailing Address - Fax:
Practice Address - Street 1:1020 SW TAYLOR ST STE 660
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2559
Practice Address - Country:US
Practice Address - Phone:360-823-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL5588104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker