Individual
ANTHONY HIGUERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 B AVE, LAKE OSWEGO, OR 97034-3012
(503) 303-7212
Mailing address
340 B AVE, LAKE OSWEGO, OR 97034-3012
(503) 303-7212
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-84848
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-84848
BACB - RBT REGISTRATION
OR
Enumeration date
04/24/2019
Last updated
04/24/2019
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