Individual
KAROLINA MISHCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN-10204542
OR BARB RBAI
OR
01
—
RBT-19-106583
BACB
OR
Enumeration date
02/28/2020
Last updated
02/28/2020
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