Individual
CLEMENT MUCYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 SE MADISON ST STE 242, PORTLAND, OR 97214-4527
(240) 923-0453
Mailing address
80 SE MADISON ST STE 242, PORTLAND, OR 97214-4527
(240) 923-0453
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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