Individual provider Active NPI

Nicole Emi Tamura, MA, BCBA

  • Behavior Analyst
  • Gresham, OR
National Provider Identifier
1033695093
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-53677 Issued in OR
Practice address
912 NE Kelly Ave
Gresham, OR 97030-5629
Phone
(855) 777-2884
NPI assigned
Jul 12, 2018
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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 1-21-53677 OR Primary

Addresses

Primary practice location

912 NE Kelly Ave
Gresham, OR 97030-5629

Mailing address

1250 Hillrise Cir
Las Cruces, NM 88011-4741
Phone (575) 288-1881

Other practice location 1

4600 25th Ave NE Ste 100
Salem, OR 97301-0338
Phone (855) 772-8847

Other practice location 2

6135 NE 80th Ave
Portland, OR 97218-4033
Phone (855) 772-8847

Other practice location 3

1800 NW 167th Pl Ste 115
Beaverton, OR 97006-4846
Phone (855) 772-8847

Other practice location 4

1600 NW 167th Pl Ste 320
Beaverton, OR 97006-4806
Phone (855) 772-8847

Other practice location 5

900 NW Eastman Pkwy Ste 38
Gresham, OR 97030-5533
Phone (855) 772-8847

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
RBT-18-54026HIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Maxim Healthcare Services Inc. PastSince Nov 1, 2020 Accepting new patients
Maxim Healthcare Services, Inc. PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1033695093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114741",
            "telephone_number": "575-288-1881",
            "fax_number": "575-288-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NE KELLY AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305629",
            "telephone_number": "855-777-2884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 25th Ave NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973010338",
            "country_code": "US",
            "telephone_number": "855-772-8847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6135 NE 80th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972184033",
            "country_code": "US",
            "telephone_number": "855-772-8847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 NW 167th Pl Ste 115",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970064846",
            "country_code": "US",
            "telephone_number": "855-772-8847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 NW 167th Pl Ste 320",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970064806",
            "country_code": "US",
            "telephone_number": "855-772-8847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 NW Eastman Pkwy Ste 38",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970305533",
            "country_code": "US",
            "telephone_number": "855-772-8847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMURA",
        "first_name": "NICOLE",
        "middle_name": "EMI",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "1-21-53677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.