Individual provider · Type 1 NPI
Divine Irambona, BEHAVIORAL TECHNICIA
Other Technician · Portland, OR
NPI number
1164930376
Active
Practice location
4949 SW Macadam Ave
Portland, OR 97239-3912
Fax (949) 253-4627
Mailing address
11037 Warner Ave # 339
Fountain Valley, CA 92708-4007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Other Technician Primary | 247200000X | None listed |
Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
2 other providers at this address
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About NPI 1164930376
Divine Irambona, BEHAVIORAL TECHNICIA's National Provider Identifier is 1164930376, issued on Jan 22, 2018. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in Portland, OR. The record was last updated on Jan 22, 2018.