| Autism Allyz Llc | |
|
17141 Se Market St Portland OR 97233-4433 | |
| (508) 826-0633 | |
| Not Available |
| Full Name | Autism Allyz Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 17141 Se Market St, Portland, Oregon |
| Authorized Official Name and Position | Victor Rie (DIRECTOR) |
| Authorized Official Contact | 5088260633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Allyz Llc 17141 Se Market St Portland OR 97233-4433 Ph: (508) 826-0633 | Autism Allyz Llc 17141 Se Market St Portland OR 97233-4433 Ph: (508) 826-0633 |
| NPI Number | 1285312892 |
|---|---|
| Provider Enumeration Date | 07/05/2023 |
| Last Update Date | 07/05/2023 |
| Certification Date | 07/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285312892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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