Jayda Michelle Anderson
Individual provider Active NPI Behavior Technician · Portland, OR
NPI 1124895073 · NPPES record last updated Dec 11, 2023
Key facts
- NPI
- 1124895073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- ABA-IN-10238223 (OR)
- Practice address
- 1827 NE 44TH Ave Ste 390
Portland, OR 97213-1461 - Phone
- (503) 963-6494
- Fax
- (310) 933-4134
- NPI assigned
- Dec 11, 2023
- 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-10238223 | OR | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Learning Network - Oregon LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | ABA-IN-10238223 | OR | Yes |
Addresses
Primary practice location
1827 NE 44TH Ave Ste 390
Portland, OR 97213-1461
Mailing address
5435 Balboa Blvd Ste 202
Encino, CA 91316-1570
Other providers in Portland, OR
- Jamie D Anderson
- Jamie Lyn Anderson
- Jared Anderson
- Jason Anderson
- Jason Anderson
- Jean Anderson
- Jenna Anderson
- Jennifer Anderson
- Jennifer Joyce Anderson
- Jessica Anderson
All providers in Portland, OR · Behavior Technician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2023. 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.