Organization
ABA OF PORTLAND CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR ERNESTO BRUZUAL (PRESIDENT)
(786) 569-3941
Entity
Organization
Contact information
Practice address
11304 SE 35TH AVE, MILWAUKIE, OR 97222-6764
(786) 569-3941
(888) 391-5328
Mailing address
11304 SE 35TH AVE, MILWAUKIE, OR 97222-6764
(786) 569-3941
(888) 391-5328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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