Individual
MARISSA DEVON HARPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7555 SW HERMOSO WAY STE 120, TIGARD, OR 97223-8684
(503) 345-3260
(503) 345-3052
Mailing address
7555 SW HERMOSO WAY STE 120, TIGARD, OR 97223-8684
(503) 345-3260
(503) 345-3052
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C8906
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500785920
GROUP MEDICAID NUMBER
OR
Enumeration date
07/27/2022
Last updated
10/08/2024
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