Individual
JENNA TOBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(541) 977-2300
Mailing address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(541) 977-2300
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
CENTER FOR SOCIAL DYNAMICS
—
Enumeration date
10/23/2018
Last updated
10/23/2018
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