Individual
SARAH ANNE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1827 NE 44TH AVE STE 390, PORTLAND, OR 97213-1461
(503) 963-6494
(310) 933-4134
Mailing address
19839 HIGHWAY 213 APT 1046, OREGON CITY, OR 97045-7976
(530) 602-2415
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10253168
OR
106S00000X
Behavior Technician
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Other
Enumeration date
03/28/2023
Last updated
03/04/2025
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