Individual
MIKENZIE A OWNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
Mailing address
19621 SW COLBY LN, HILLSBORO, OR 97123-8737
(209) 479-1263
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10252585
OR
Other
Enumeration date
02/10/2025
Last updated
03/05/2025
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