Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Maryanne Jaconis, PHD

Individual provider Clinical Psychologist · NPI 1295240190

Dr. Maryanne Jaconis, PHD is a Clinical Psychologist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2017
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1742 SE Clatsop St
Portland, OR 97202-7305
Phone: (503) 908-3767
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 2882 (OR)

Record details

NPI number1295240190
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedDecember 13, 2017
Last updated in NPPESDecember 13, 2017

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