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Individual

JOHNATHAN JOSE LIPORADA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
22415 SE 231ST ST STE B103, MAPLE VALLEY, WA 98038-5002
(425) 906-4300
Mailing address
22415 SE 231ST ST STE B103, MAPLE VALLEY, WA 98038-5002

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/08/2021
Last updated
04/08/2021
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