Individual
MYRIRAM YVONNE POLANCO ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSWA
Contact information
Practice address
510 E WASHINGTON ST, CARLTON, OR 97111-9614
(503) 891-7321
Mailing address
510 E WASHINGTON ST, CARLTON, OR 97111-9614
(503) 891-7321
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A10282
OR
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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