Individual
NIRMANI TILAKASENA SAUCEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C7621
OR
Other
Enumeration date
10/10/2019
Last updated
10/19/2023
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