Individual
LILLIAN MAYA WADDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7127 SE 36TH AVE, PORTLAND, OR 97202-8327
(503) 702-7810
Mailing address
7127 SE 36TH AVE, PORTLAND, OR 97202-8327
(503) 702-7810
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/23/2025
Last updated
04/24/2025
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