Individual
MAIA WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2333 SE 12TH AVE, PORTLAND, OR 97214-5323
(503) 984-5961
Mailing address
12141 NE HALSEY ST, PORTLAND, OR 97220-2042
(503) 984-5961
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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