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1184461360
JAX ROMAN FLICK
PORTLAND, OR
NPI
1184461360
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: OR ABA-IN-10245553)
Enumeration Date
2024-07-13
Last Update Date
2024-07-13
Business Address
JAX ROMAN FLICK
1827 NE 44TH AVE
PORTLAND, OR 97213-1443
Phone number: 503-963-6494
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Mailing Address
JAX ROMAN FLICK
1450 N PRESCOTT ST APT 320
PORTLAND, OR 97217-3206
Phone number: 801-854-8865
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