Individual
JACY SAUCEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14781 SW 109TH AVE APT 3, PORTLAND, OR 97224-3223
(503) 235-0021
Mailing address
14781 SW 109TH AVE APT 3, PORTLAND, OR 97224-3223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11425
OR
Other
Enumeration date
11/22/2013
Last updated
09/05/2024
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