Junior Alexis

Individual provider Active NPI Behavior Technician · Portland, OR

NPI 1184192015 · NPPES record last updated Nov 8, 2018

Key facts

NPI
1184192015
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102
Phone
(510) 679-3545
NPI assigned
Nov 8, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102

Mailing address

25604 SW Canyon Creek Rd Apt T101
Wilsonville, OR 97070-7683

Other providers in Portland, OR

All providers in Portland, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.