CHILDRENS INTENSIVE THERAPY NORTHWEST
Restorative Service Providers at Raymond St, Portland, OR

License number
Oregon 4970
Category
Restorative Service Providers
Type
Pediatrics
License number
Oregon 5680
Category
Restorative Service Providers
Type
Pediatrics
Owner
Name: MR. DARREN DAVID BRAULT
Title: OWNER
Phone: (971) 570-5043
Address
Address 2
7203 SE Raymond St, Portland, OR 97206
12948 SE Winston Rd, Happy Valley, OR 97089
National Provider ID: 1477886232
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about CHILDRENS INTENSIVE THERAPY NORTHWEST at bizstanding.com

CHILDRENS INTENSIVE THERAPY NORTHWEST INC

Happy Valley, OR  -  Portland, OR

Industry:
Specialty Outpatient Clinic
Doing business as:
Childrens Intensive Therapy Northwest
Registration:
Sep 11, 2009
Addresses:
12948 SE Winston Rd, Damascus, OR 97089 (Mailing)
7203 SE Raymond St, Portland, OR 97206 (Physical)
3810 SE Ctr St, Portland, OR 97202
State ID:
62974796
Business type:
DOMESTIC BUSINESS CORPORATION
Principal:
Darren D. Brault (Principal)
Agent:
Darren Davidbrault,12948 SE Winston Rd, Damascus, OR 97089 (Physical)

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