Individual
YESSICA MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 NE M. L. K. JR. BLVD., PORTLAND, OR 97212
(503) 327-8205
Mailing address
3500 NE M L K JR BLVD, PORTLAND, OR 97212-2093
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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