Individual
MARIKO KANATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15532 SW PACIFIC HWY, SUITE C1B - 605, TIGARD, OR 97224
(530) 924-4262
Mailing address
15532 SW PACIFIC HWY, SUITE C1B - 605, TIGARD, OR 97224
(530) 924-4262
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
08/12/2020
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