| Doctor Name: | EMILY MARIE KETOLA |
| NPI Number: | 1003141672 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | L5681 |
| Business Practice Address: | 9775 Se Sunnyside Rd Ste 200 Clackamas, OR - 970155721 |
| Business Phone Number: | 5037943830 |
| Business Fax Number: | 5037943850 |
| Mailing Address: | 2051 Kaen Rd, Suite 367 OREGON CITY |
| State: | OR |
| Postal Code: | 970454035 |
| Phone Number: | 5037425300 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2009 |
| NPI Last Update Date: | 03/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | L5681 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |