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Individual

KATHERINE BOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1675 SW MARLOW AVE, PORTLAND, OR 97225-5104
(415) 748-8052
Mailing address
1804 SE MADISON ST, PORTLAND, OR 97214-3822
(503) 508-8179

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/14/2018
Last updated
06/14/2018
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