Individual
SOPHIA GRACE REITEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(866) 523-4268
Mailing address
668 MCVEY AVE UNIT 80, LAKE OSWEGO, OR 97034-4811
(208) 515-6575
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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