Individual
JESSICA MAHMOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 NE COUCH ST, PORTLAND, OR 97232-2922
(503) 233-6090
Mailing address
8715 N WASHBURNE AVE, PORTLAND, OR 97217-7314
(973) 981-2100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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