Individual
JENNIFER ISLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1503 N HAYDEN ISLAND DR UNIT 18, PORTLAND, OR 97217-8205
(510) 943-7843
Mailing address
1503 N HAYDEN ISLAND DR UNIT 18, PORTLAND, OR 97217-8205
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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