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1225308588
MARYSOL JIMENEZ
PORTLAND, OR
NPI
1225308588
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 10-P-17U)
Enumeration Date
2012-01-04
Last Update Date
2012-01-04
Business Address
-- MARYSOL JIMENEZ CADC I
231 SE 12TH AVE
PORTLAND, OR 97214-1342
Phone number: 503-546-9975
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Mailing Address
-- MARYSOL JIMENEZ CADC I
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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