Individual
JESSICA CHAVEZ CAZARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 SE LAKE RD STE 175, PORTLAND, OR 97222-2137
(682) 250-7500
Mailing address
2912 TWINFLOWER ST, FOREST GROVE, OR 97116-1395
(503) 468-2545
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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