Hannah Martynowicz
Individual provider Active NPI Behavior Technician · Bend, OR
NPI 1003570409 · NPPES record last updated Oct 22, 2021
Key facts
- NPI
- 1003570409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- ABA-IN-10217449 (OR)
- Practice address
- 19800 Village Office CT Ste 104
Bend, OR 97702-1813 - Phone
- (541) 306-3483
- Fax
- (541) 639-8909
- NPI assigned
- Oct 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ABA-IN-10217449 | OR | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Behavioral Intervention, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | ABA-IN-10217449 | OR | Yes |
Addresses
Primary practice location
19800 Village Office CT Ste 104
Bend, OR 97702-1813
Mailing address
19800 Village Office CT Ste 104
Bend, OR 97702-1813
Phone (541) 306-3483
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.