Most Relevant Information
Provider Data
| NPI Number: | 1003194366 |
| Provider Name: | GLYKERIA MANIS LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | L7439 |
Most Important Dates
| Enumeration Date: | 08/03/2011 |
| Last Updated: | 11/02/2023 |
Provider Practice Location
9135 SW BARNES RD
PORTLAND
OR
972256646
Practice Location Phone/Fax
| Phone: | 5032161234 |
| Fax: |
Provider Mailing Location
PO BOX 3396
PORTLAND
OR
972083396
Provider Mailing Phone/Fax
| Phone: | 5032162380 |
| Fax: |