MEDICARE: CECILIA RAMIREZ ESPINOZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1780210583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA RAMIREZ ESPINOZA

Provider Business Mailing Address
First Line	:	107 N TRADE ST APT A
Second Line	:
City	:	AMITY
State	:	OR
Zip	:	97101-2827
Country	:	US
Telephone Number	:	971-259-9282
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 N TRADE ST APT A
Second Line	:
City	:	AMITY
State	:	OR
Zip	:	97101-2827
Country	:	US
Telephone Number	:	971-259-9282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2020
Last Update Date	:	03/12/2020

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Directions to “ CECILIA RAMIREZ ESPINOZA ” Practice Location

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