Individual
MARISOL CHRISTINE BLASKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
10822 SE 82ND AVE, STE K, HAPPY VALLEY, OR 97086-7658
(503) 654-7444
(503) 654-0392
Mailing address
PO BOX 12403, PORTLAND, OR 97212
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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