Individual
KERRI PERISICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
12636 SE STARK ST, PLAZA 125, BUILDING J, PORTLAND, OR 97233-1058
(503) 253-4600
(503) 253-4609
Mailing address
12636 SE STARK ST, PLAZA 125, BUILDING J, PORTLAND, OR 97233-1058
(503) 253-4600
(503) 253-4609
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230442
DMAP
OR
Enumeration date
02/26/2008
Last updated
06/10/2008
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