Individual
MARK BROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5408 NE 29TH AVE, PORTLAND, OR 97211-6244
(503) 686-1786
Mailing address
2185 SE CEDAR PARK CT, HILLSBORO, OR 97123-7203
(971) 344-4447
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
10/15/2021
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