Individual
MARISSA ILNITZKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5228 NE HOYT ST BLDG B, PORTLAND, OR 97213-3055
(503) 215-1602
(503) 215-6477
Mailing address
5228 NE HOYT ST BLDG B, PORTLAND, OR 97213-3055
(503) 215-1602
(503) 215-6477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A17195
OR
Other
Enumeration date
06/04/2026
Last updated
06/04/2026
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