Individual
MRS. LISA MARCHELL GOULD WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
12650 SE STARK ST, PORTLAND, OR 97233-1058
(503) 477-9527
(503) 477-9527
Mailing address
12650 SE STARK ST, PORTLAND, OR 97233-1058
(503) 477-9527
(503) 477-9529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1076095
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273905
—
OR
05
—
7684103
—
WA
Enumeration date
01/09/2007
Last updated
07/21/2022
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