Individual provider · Type 1 NPI

Mary Chakhtoura

Clinical Social Worker · Portland, OR

NPI number 1679212427 Active

Practice location

3500 NE Martin Luther King Jr Blvd Ste 200
Portland, OR 97212-2093

Mailing address

2039 E Burnside St
Portland, OR 97214-1649

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XL17969 (OR)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1679212427

Mary Chakhtoura's National Provider Identifier is 1679212427, issued on May 31, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Portland, OR. The record was last updated on May 13, 2026.