Provider Demographics
NPI:1487986576
Name:MAY, EDWARD JAMES (MSW/SWAIC)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAMES
Last Name:MAY
Suffix:
Gender:M
Credentials:MSW/SWAIC
Other - Prefix:MR
Other - First Name:EDDIE
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8150 SW BARNES RD
Mailing Address - Street 2:#D203
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6372
Mailing Address - Country:US
Mailing Address - Phone:253-225-3434
Mailing Address - Fax:
Practice Address - Street 1:1500 NE IRVING ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2243
Practice Address - Country:US
Practice Address - Phone:503-258-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC601291761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical