Marissa Nicole Haide
Adult Companion in Portland, OR. Individual provider (NPI-1).
NPI number1033677752
StatusActive
Last updated in NPPESMar 12, 2019
Details
- NPI
- 1033677752
- Entity type
- Individual (NPI-1)
- Name
- Marissa Nicole Haide
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2019
- Last updated
- Mar 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 372600000X | Adult Companion | – | – | Yes |
Practice location
847 Ne 19th Ave Ste 100Portland, OR 97232-2684
Phone 503-238-0769
Mailing address
Po Box 8459Portland, OR 97207-8459
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All 864 Adult Companion providers in Portland · All 48,847 providers in Portland
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