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Mariella Mandujano
Peer Specialist in Milwaukie, Oregon
NPI 1144911231

Mariella Mandujano is a Peer Specialist based in Tigard, OR. Mariella Mandujano practices in Milwaukie, OR. The NPI Number for Mariella Mandujano is 1144911231 and holds a License No. THW000107858 (Oregon).

The current practice location address for Mariella Mandujano is 11097 Se 21St Ave, Milwaukie, OR and can be reached out via phone at 503-974-9025.

Location: 11097 Se 21St Ave, Milwaukie, OR, 97223-1581
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144911231
Provider Name
Mariella Mandujano
Credential
Provider Entity Type
Individual
Gender
Female
Address
11097 Se 21St Ave, Milwaukie, OR, 97223-1581
Phone Number
503-974-9025
Fax Number
Provider Enumeration Date
05/18/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11097 Se 21St Ave
City
Milwaukie
State
Oregon
Zip
97222-7640
Phone Number
503-974-9025
Fax Number
person
Provider Business Mailing Address Details
Address
11097 Se 21St Ave
City
Milwaukie
State
Oregon
Zip
97222-7640
Phone Number
503-974-9025
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000107858 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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