Individual
ANDREW LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(503) 679-3545
Mailing address
11127 NE SCHUYLER ST UNIT A, PORTLAND, OR 97220-3086
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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