Individual
ANNETTE MARIE MAJEKODUNMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FSS
Contact information
Practice address
4735 NE MALLORY AVE, PORTLAND, OR 97211-3334
(971) 263-3334
Mailing address
4735 NE MALLORY AVE, PORTLAND, OR 97211-3334
(971) 263-3334
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000003469
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000003469
OREGON HEALTH AUTHORITY
OR
01
—
THW000003469
OREGON HEALTH AUTHORITY
OR
Enumeration date
07/12/2021
Last updated
07/12/2021
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