Most Relevant Information
Provider Data
| NPI Number: | 1003440009 |
| Provider Name: | ELISE GILMORE |
| Entity Type: | Individual |
| Taxonomy Code: | 106E00000X |
| Specialty: | Assistant Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/27/2020 |
| Last Updated: | 02/27/2020 |
Provider Practice Location
707 NE COUCH ST
PORTLAND
OR
972322922
Practice Location Phone/Fax
| Phone: | 5035424603 |
| Fax: | 5032336093 |
Provider Mailing Location
707 NE COUCH ST
PORTLAND
OR
972322922
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |