Individual provider Active NPI

Samantha Joelle Sposito

  • Behavior Analyst
  • Portland, OR
National Provider Identifier
1033678685
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
SPOSISJ033O9 Issued in WA
Practice address
6707 N Van Houten Ave
Portland, OR 97203-5243
Phone
(509) 475-5841
NPI assigned
Mar 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X SPOSISJ033O9 WA Primary

Addresses

Primary practice location

6707 N Van Houten Ave
Portland, OR 97203-5243

Mailing address

6707 N Van Houten Ave
Portland, OR 97203-5243
Phone (509) 475-5841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SPOSISJ033O9WAMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1033678685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 N VAN HOUTEN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972035243",
            "telephone_number": "509-475-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 N VAN HOUTEN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972035243",
            "telephone_number": "509-475-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOSITO",
        "first_name": "SAMANTHA",
        "middle_name": "JOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "SPOSISJ033O9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.