Individual
KEENAN WADNIZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13128 SE COOPER ST, PORTLAND, OR 97236-4573
(503) 803-2177
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
05/11/2026
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