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1295240190
MARYANNE JACONIS
PORTLAND, OR
NPI
1295240190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: OR 2882)
Enumeration Date
2017-12-13
Last Update Date
2017-12-13
Business Address
Dr. MARYANNE JACONIS Ph.D.
1742 SE CLATSOP ST
PORTLAND, OR 97202-7305
Phone number: 503-908-3767
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Mailing Address
Dr. MARYANNE JACONIS Ph.D.
1742 SE CLATSOP ST
PORTLAND, OR 97202-7305
Phone number: 503-908-3767
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