Individual
JAZZ GUAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
665 NW HOYT ST, PORTLAND, OR 97209-3769
(503) 280-4000
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
IN-10210983
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/28/2020
Last updated
07/12/2023
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