Individual
JACK RADCLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7935A SE RAYMOND ST, PORTLAND, OR 97206-4261
(951) 551-6545
Mailing address
912 NE KELLY AVE, GRESHAM, OR 97030-5629
(503) 912-5502
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
F2433504
CA
Other
Enumeration date
03/07/2022
Last updated
11/07/2025
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