NPI 1164930376

Divine Irambona, BEHAVIORALTECHNICIA

Practitioner Other Technician Portland, OR

Practice location

Address: 4949 SW Macadam Ave, Portland, OR 97239-3912
Phone: (800) 273-9292
Fax: (949) 253-4627
Mailing address: 11037 Warner Ave # 339, Fountain Valley, CA 92708-4007

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Oregon →

Registry record

NPI: 1164930376
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Jan 2018
Record last updated: 22 Jan 2018

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.