NPIMap

Organization Active NPI

Columbia River Gorge Behavior Services, LLC

  • Behavior Analyst
  • White Salmon, WA
National Provider Identifier
1154835841
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
COLUMBIA RIVER GORGE BEHAVIOR SERVICES, LLC
Practice address
185 NE Snohomish Ave Unit 724
White Salmon, WA 98672-0160
Phone
(509) 396-6592
Fax
(509) 834-7266
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Authorized official

Name
Nicholas Santillano, BCBA, LBANPI 1003206566
Title
Owner
Phone
(509) 396-6592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

185 NE Snohomish Ave Unit 724
White Salmon, WA 98672-0160

Mailing address

185 NE Snohomish Ave Unit 724
White Salmon, WA 98672-0160
Phone (509) 396-6592

Other names 1

  • Gorge Behavior Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

185 NE Snohomish Ave
Unit 724
White Salmon, WA 98672
Phone (509) 396-6592

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1154835841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 NE SNOHOMISH AVE UNIT 724",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986720160",
            "telephone_number": "509-396-6592",
            "fax_number": "509-834-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 NE SNOHOMISH AVE UNIT 724",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986720160",
            "telephone_number": "509-396-6592",
            "fax_number": "509-834-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RIVER GORGE BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "SANTILLANO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-396-6592",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gorge Behavior Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Salmon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.