Individual
MACYN MCCUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2717 NE BROADWAY ST, PORTLAND, OR 97232-1722
(971) 256-3400
Mailing address
2717 NE BROADWAY ST, PORTLAND, OR 97232-1722
(971) 256-3400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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