Individual
ANTHONY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8019 NE 13TH AVE, VANCOUVER, WA 98665-9604
(360) 784-0076
Mailing address
8019 NE 13TH AVE, VANCOUVER, WA 98665-9604
(360) 784-0076
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61336053
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB61336053
WA DEPT OF HEALTH
WA
Enumeration date
09/23/2022
Last updated
09/23/2022
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