Individual
BREIANA NICOLE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 SE LAKE RD STE 175, PORTLAND, OR 97222-2137
(628) 250-7500
Mailing address
22408 SE NAOMI DR, DAMASCUS, OR 97089-8214
(971) 266-7657
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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