Individual
SAMANTHA LYNN IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 E LINCOLN RD # RC, WOODBURN, OR 97071-5137
(503) 982-9300
Mailing address
1220 MCGEE CT NE APT 103, KEIZER, OR 97303-9442
(971) 599-8899
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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