Individual
MAYA MERSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
316 SE 123RD AVE STE A67, VANCOUVER, WA 98683-4056
(503) 702-0178
Mailing address
3011 SE 142ND PL, PORTLAND, OR 97236-2612
(503) 702-0178
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
11/19/2018
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