MR. Jack Lee Otterstrom, LCSW
NPI #1922163096 in Independence, Oregon
Provider Information
- NPI Number
- 1922163096
- Entity Type
- Individual
- Name
- MR. Jack Lee Otterstrom, LCSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Credential
- LCSW
- Enumeration Date
- Dec 27, 2006
- Last Updated
- Sep 6, 2022
Practice Location
- Address
- 656 JASMINE CIR
- City
- Independence
- State
- Oregon
- ZIP Code
- 97351-9578
- Phone
- (541) 231-8023
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Social Worker - Clinical — Clinical |
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