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1417694274
CHARLES MOORE WYNNS
PORTLAND, OR
NPI
1417694274
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-05-13
Last Update Date
2022-05-13
Business Address
CHARLES MOORE WYNNS
1675 SW MARLOW AVE STE 200
PORTLAND, OR 97225-5102
Phone number: 866-523-4268
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Mailing Address
CHARLES MOORE WYNNS
DEPT LA 22763
PASADENA, CA 91185-2763
Phone number: 866-523-4268
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