Individual
TRISTAN PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5415 SE MILWAUKIE AVE, PORTLAND, OR 97202-4940
(785) 764-4374
Mailing address
18670 SW BOONES FERRY RD APT 26, TUALATIN, OR 97062-8489
(785) 764-4374
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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