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Individual

LILLIAN DOUGALAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15290 SW ROYALTY PKWY, TIGARD, OR 97224-4059
(971) 256-4050
Mailing address
6125 BONITA RD APT J203, LAKE OSWEGO, OR 97035-2240

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-101287
CA
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/26/2021
Last updated
05/26/2021
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