Individual
GISELLE REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 SW 68TH PKWY STE 200, PORTLAND, OR 97223-9058
(425) 477-4216
Mailing address
2137 SE CEDAR PARK CT, HILLSBORO, OR 97123-7203
(541) 460-3682
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A14067
OR
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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