Individual
DOLORES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 SE POWELL BLVD, PORTLAND, OR 97202-2345
(503) 233-6121
Mailing address
2020 SE POWELL BLVD, PORTLAND, OR 97202-2345
(503) 233-6121
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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