Individual
SHALAINE JOY MISTRETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12540 SW 68TH AVE STE B, TIGARD, OR 97223-8597
(503) 433-3996
Mailing address
6986 SW STANFORD CT, PORTLAND, OR 97223-9585
(503) 880-0136
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7632
OR
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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