Individual
ADAM DEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
9115 SW OLESON RD STE 100, PORTLAND, OR 97223-6876
(971) 236-0915
Mailing address
11665 AVENA PL STE 204, SAN DIEGO, CA 92128-2428
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-19744
CA
Other
Enumeration date
12/28/2017
Last updated
12/17/2019
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