Individual
DIANA RUBY MARTINEZ VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBAI
Contact information
Practice address
249 SE 162ND AVE, PORTLAND, OR 97233-3805
(503) 750-3410
Mailing address
249 SE 162ND AVE, PORTLAND, OR 97233-3805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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