Individual
SHIRA DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3424 NE TILLAMOOK ST., PORTLAND, OR 97212
(805) 807-4922
Mailing address
3424 NE TILLAMOOK ST, PORTLAND, OR 97212-5155
(805) 807-4922
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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