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Individual

JACKIE ELISE CANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
3303 S BOND AVE BUILDING 1, 15TH FLOOR, PORTLAND, OR 97239
(503) 494-5947
Mailing address
1100 SE SHERMAN ST APT 101, PORTLAND, OR 97214-5269

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17581
OR

Other

Enumeration date
09/27/2022
Last updated
09/27/2022
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