Individual
ALEXANDER CRISCUOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
Mailing address
450 NW SKYLINE BLVD, PORTLAND, OR 97229-6800
(503) 296-9571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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