Individual
KENYA I GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 NE 197TH AVE, PORTLAND, OR 97230-8006
(503) 473-1876
(877) 831-7109
Mailing address
1537 SE ELLIOTT AVE, PORTLAND, OR 97214-4807
(209) 417-2976
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
10224329
OR
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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