Individual
VICTORIA COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
5340 SE MILWAUKIE AVE, #7, PORTLAND, OR 97202-3281
(800) 273-4292
(714) 596-6274
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
ABA-B-10183254
OR
106S00000X
Behavior Technician
ABA-IN-10179391
OR
247200000X
Other Technician
—
—
Other
Enumeration date
02/24/2012
Last updated
05/05/2017
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