Individual
DUSTIN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
11850 SE 26TH AVE APT 311, MILWAUKIE, OR 97222-7770
(503) 984-8528
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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