Individual
MAYRA ITZEL CAPISTRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N DIXON ST, PORTLAND, OR 97227-1804
(503) 916-2000
Mailing address
7500 SW CANYON LN, PORTLAND, OR 97225-3810
(323) 485-7246
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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