Individual
JASMINE VANDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8800 SE CAUSEY LOOP APT C204, HAPPY VALLEY, OR 97086-7565
(503) 960-0493
Mailing address
8800 SE CAUSEY LOOP APT C204, HAPPY VALLEY, OR 97086-7565
(503) 960-0493
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A378323
ID
OR
Enumeration date
02/07/2019
Last updated
02/07/2019
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