Individual
MRS. CLARISA WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
5601 SE 122ND AVE, PORTLAND, OR 97236-4601
(503) 761-3181
Mailing address
810 SW DOLPH ST, PORTLAND, OR 97219-4569
(503) 761-3181
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6891
OR
Other
Enumeration date
08/07/2007
Last updated
12/27/2021
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