MEDICARE: MARIA PAULA GONZALEZ

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	1-24-75317	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982238408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PAULA GONZALEZ

Provider Business Mailing Address
First Line	:	11000 SW BARBUR BLVD STE 100101
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-8691
Country	:	US
Telephone Number	:	971-228-9848
Fax Number	:	503-907-6855

Provider Business Practice Location Address
First Line	:	11000 SW BARBUR BLVD STE 100101
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-8691
Country	:	US
Telephone Number	:	971-228-9848
Fax Number	:	503-907-6855

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

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	06/01/2026

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