Individual
VANESSA ROSE WISSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2120 SW JEFFERSON ST, SUITE B200, PORTLAND, OR 97201-7727
(503) 244-4083
Mailing address
1969 SW PARK AVE APT 706, PORTLAND, OR 97201-3167
(408) 693-0270
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-16-20405
NV
Other
Enumeration date
05/30/2016
Last updated
01/29/2017
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