Individual
MARISSA LYNETTE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NE MLK JR BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
30 NE MLK JR BLVD, PORTLAND, OR 97232-2941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
OR
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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