Individual
AUSTIN JOHN ARCHULETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1851 NW CIVIC DR, GRESHAM, OR 97030-5566
(503) 422-0180
Mailing address
2673 SE WENDY DR, GRESHAM, OR 97080-9210
(503) 422-0180
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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