Individual
MR. BRADLEY RAY GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
660 NW 9TH AVE, CANBY, OR 97013-2713
(971) 219-5691
Mailing address
660 NW 9TH AVE, CANBY, OR 97013-2713
(971) 219-5691
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
OR
Other
Enumeration date
01/27/2022
Last updated
02/03/2022
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