Individual
MARIA JOSEPHINA JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3922 SW MAWRCREST AVE, GRESHAM, OR 97080-8690
(503) 425-9240
Mailing address
3922 SW MAWRCREST AVE, GRESHAM, OR 97080-8690
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
02/13/2026
Last updated
03/11/2026
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