Individual
JORDAN GAKSTATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5847 NE 122ND AVE STE 101, PORTLAND, OR 97230-1079
(971) 339-7040
Mailing address
5847 NE 122ND AVE STE 101, PORTLAND, OR 97230-1079
(971) 339-7040
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-57427
OR
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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