Individual
ELLIOTT WAKSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 460-7022
Mailing address
9830 NE CASCADES PKWY STE 200, PORTLAND, OR 97220-6834
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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