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1629634431
SHALAINE JOY MISTRETTA
TIGARD, OR
NPI
1629634431
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L7632)
Enumeration Date
2019-05-16
Last Update Date
2019-05-16
Business Address
SHALAINE JOY MISTRETTA
12540 SW 68TH AVE STE B
TIGARD, OR 97223-8597
Phone number: 503-433-3996
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Mailing Address
SHALAINE JOY MISTRETTA
6986 SW STANFORD CT
PORTLAND, OR 97223-9585
Phone number: 503-880-0136
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