Individual
AIDAN N RODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9115 SW OLESON RD, STE 100, PORTLAND, OR 97223
(971) 236-0915
Mailing address
2571 SE ELLIOTT DR, GRESHAM, OR 97080-8271
(541) 864-0801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
08/06/2019
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