NPI 1063193464

Maru Genemo

Practitioner Foster Care Agency Portland, OR

Practice location

Address: 8060 SW Greenhouse Ln, Portland, OR 97225-3869
Phone: (240) 432-2374

Registered specialties

Foster Care Agency Primary

Agencies Taxonomy 253J00000X

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Registry record

NPI: 1063193464
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jul 2023
Record last updated: 27 Jul 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.