Individual
BRANDON JEROME FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1851 NW CIVIC DR, GRESHAM, OR 97030-5566
(971) 292-1050
Mailing address
527 NE 81ST AVE, PORTLAND, OR 97213-6930
(503) 498-1813
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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