Individual
JACLYN RAE PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15298 SW ROYALTY PKWY # 300, TIGARD, OR 97224-3904
(971) 256-4050
Mailing address
15298 SW ROYALTY PKWY # 300, TIGARD, OR 97224-3904
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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