Provider Demographics
NPI:1811253461
Name:LATRONICA, BRITANIA (PHD)
Entity type:Individual
Prefix:DR
First Name:BRITANIA
Middle Name:
Last Name:LATRONICA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11005 SW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8734
Mailing Address - Country:US
Mailing Address - Phone:971-417-5500
Mailing Address - Fax:
Practice Address - Street 1:1340 SW BERTHA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2172
Practice Address - Country:US
Practice Address - Phone:971-417-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1413103TB0200X
KS2210103TB0200X
OR2483103TB0200X
KS2399103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR12363430OtherCAQH