Individual
JIMENA VICUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
12014 SE MILL PLAIN BLVD STE 120, VANCOUVER, WA 98684-4044
(208) 297-1405
Mailing address
5480 NE 36TH AVE APT 204, PORTLAND, OR 97211-7475
(208) 297-1405
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/25/2026
Last updated
06/25/2026
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