Provider Demographics
NPI:1538475652
Name:PALMER, MARISSA A (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 NE CASCADES PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-6832
Mailing Address - Country:US
Mailing Address - Phone:503-239-8101
Mailing Address - Fax:503-408-5021
Practice Address - Street 1:9830 NE CASCADES PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-6832
Practice Address - Country:US
Practice Address - Phone:503-239-8101
Practice Address - Fax:503-408-5021
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker