Organization
SYNERGY AUTISM CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA AVILA (OWNER/MEMBER)
(503) 432-8760
Entity
Organization
Contact information
Practice address
7739 SW CAPITOL HWY, #220, PORTLAND, OR 97219-2571
(503) 432-8760
Mailing address
7739 SW CAPITOL HWY, #220, PORTLAND, OR 97219-2571
(503) 432-8760
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
GRANDFATHERED-IN
OR
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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