Organization
THE ESTUARY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEE ANN HERNANDEZ (EXECUTIVE DIRECTOR)
(971) 804-0276
Entity
Organization
Contact information
Practice address
7475 SW OLESON RD, PORTLAND, OR 97223-7474
(971) 804-0276
(503) 296-2972
Mailing address
15585 NW BARKTON ST, BEAVERTON, OR 97006-5349
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500816468
—
OR
Enumeration date
04/16/2021
Last updated
08/12/2025
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