Individual
EVELYN JOANNA HENDIG
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
910 W SAN MARCOS BLVD STE 104, SAN MARCOS, CA 92078-1116
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-60298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-60298
TRICARE
CA
Enumeration date
12/18/2018
Last updated
07/20/2022
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