Individual
MADELINE LOUISE STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
Mailing address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10254104
OR
Other
Enumeration date
06/24/2010
Last updated
04/02/2025
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