Individual
ELIZABETH JOANNA CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 NE 197TH AVE, PORTLAND, OR 97230-8006
(503) 473-1876
Mailing address
908 SALISBURY GRN, VIRGINIA BEACH, VA 23452-6123
(757) 406-7397
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IN-10235061
OR
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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