Individual
MADISON PORT-SONENSHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1827 NE 44TH AVE STE 390, PORTLAND, OR 97213-1461
(503) 963-6494
(310) 933-4161
Mailing address
3333 N HUNT ST, PORTLAND, OR 97217-7169
(707) 293-5288
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10226701
OR
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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