Individual
RACHEL M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR ANALYST
Contact information
Practice address
4949 SW MACADAM AVE # 30, PORTLAND, OR 97239-3912
(888) 273-4292
(888) 293-3374
Mailing address
11037 WARNER AVE # 339, FOUNTAIN VALLEY, CA 92708-4007
(714) 848-8319
(714) 596-6274
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
ABA-B-10209046
OR
106S00000X
Behavior Technician
RBT-18-53582
CO
Other
Enumeration date
09/14/2018
Last updated
12/22/2020
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