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Individual

MARRISSA GOTTLOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
421 SW OAK ST, PORTLAND, OR 97204-1817
(503) 988-3999
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442

Taxonomy

Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary

Other

Enumeration date
06/01/2012
Last updated
06/01/2012
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