Individual
MARIA LYNN WILLIQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1235 SE DIVISION ST STE 104, PORTLAND, OR 97202-1055
(206) 327-8592
Mailing address
7821 SE 29TH AVE, PORTLAND, OR 97202-8832
(425) 349-8300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
T1368
OR
Other
Enumeration date
10/07/2010
Last updated
03/17/2018
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