IndividualActive
Mary Iannuccillo, MSW
NPI 1023231982 · Clinical Social Worker · Portland, OR
Mary Iannuccillo, MSW is a Clinical Social Worker provider in Portland, OR (NPI 1023231982).
Provider details
- NPI number
- 1023231982
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- MSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0759 (OR)
Practice location
2250 Nw Flanders St
Suite 103
Portland, OR 97210-3443
Phone: (503) 796-9242
Fax: (503) 657-8310
Street-level locationGet directions
Mailing address
2250 Nw Flanders St
Portland, OR 97210-3443
Registry dates
- Enumerated
- 2007-04-10
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.