Most Relevant Information
Provider Data
| NPI Number: | 1003515636 |
| Provider Name: | ALEXANDER CRISCUOLO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/02/2023 |
| Last Updated: | 03/02/2023 |
Provider Practice Location
18765 SW BOONES FERRY RD STE 100
TUALATIN
OR
970628607
Practice Location Phone/Fax
| Phone: | 5036121000 |
| Fax: |
Provider Mailing Location
450 NW SKYLINE BLVD
PORTLAND
OR
972296800
Provider Mailing Phone/Fax
| Phone: | 5032969571 |
| Fax: |