NPI 1003589672

Jordan Alexander Moreno

Practitioner Behavior Technician Salem, OR

Practice location

Address: 3400 State Street, Suite G-750 Salem, Or 97301, Salem, OR 97301
Phone: (971) 273-7502

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence B159150 (OR)

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Registry record

NPI: 1003589672
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jul 2021
Record last updated: 29 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.