Active NPI
Emily Wiessner
- Behavior Analyst
- Gresham, OR
National Provider Identifier
1124733779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1851 NW Civic Dr
Gresham, OR 97030-5566 - Phone
- (971) 292-1050
- NPI assigned
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1851 NW Civic Dr
Gresham, OR 97030-5566
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Other practice location 1
3669 NE John Olsen Ave
Hillsboro, OR 97124-5815
Phone (503) 927-1179
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775433600000",
"number": "1124733779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PKWY STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1851 NW CIVIC DR",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970305566",
"telephone_number": "971-292-1050"
}
],
"practiceLocations": [
{
"address_1": "3669 NE John Olsen Ave",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971245815",
"country_code": "US",
"telephone_number": "503-927-1179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIESSNER",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-18",
"last_updated": "2026-04-06",
"certification_date": "2026-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"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 Apr 6, 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.