Individual
KELSEY MARIE ANSOTEGUI-MARQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD STE 100, PORTLAND, OR 97223-6876
(091) 597-1236
Mailing address
9115 SW OLESON RD STE 100, PORTLAND, OR 97223-6876
(091) 597-1236
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
1073131058.
OR
Other
Enumeration date
07/07/2020
Last updated
07/08/2020
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