Individual
MARYSOL JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
231 SE 12TH AVE, PORTLAND, OR 97214-1342
(503) 546-9975
(503) 546-9976
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-P-17U
OR
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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