Individual
MR. JUAN M JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
529 W 6TH ST, PORT ANGELES, WA 98362-5805
(940) 627-6918
Mailing address
529 WEST 6TH ST, PORT ANGELES, WA 98362-5805
(360) 643-9400
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
WA
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
09/04/2019
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