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Organization

MAPLE STAR OREGON, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MICHELLE OTTAVIANO (EXECUTIVE DIRECTOR)
(503) 729-4806
Entity
Organization

Contact information

Practice address
9570 SW BARBUR BLVD STE 214, PORTLAND, OR 97219-5412
(503) 290-1900
(503) 928-5554
Mailing address
9570 SW BARBUR BLVD STE 214, PORTLAND, OR 97219-5412
(503) 290-1900
(503) 928-5554

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
OR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
09/24/2008
Last updated
01/07/2026
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