Individual
XAVIER RICARDO CHAVEZ IBABAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
244 W MAIN ST, HILLSBORO, OR 97123-3961
(503) 846-8766
Mailing address
244 W MAIN ST, HILLSBORO, OR 97123-3961
(503) 846-8766
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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