Individual
FIONA RAINE SAMODUROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 NE 136TH AVE STE 220, VANCOUVER, WA 98684-6951
(360) 952-7060
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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