Jax Roman Flick

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

ABA-IN-10245553 Issued in OR

Practice address

1827 NE 44TH Ave
Portland, OR 97213-1443

Phone

(503) 963-6494

NPI assigned

Jul 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1184461360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N PRESCOTT ST APT 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173206",
            "telephone_number": "801-854-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 NE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131443",
            "telephone_number": "503-963-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICK",
        "first_name": "JAX",
        "middle_name": "ROMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "ABA-IN-10245553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lee Fletter, AU.D, CCC-A
• Rhone Dion Fleuerestil
• Philip A Fleury, ANP
• Flex Chiropractic LLC (Flex Chriopractic Movment Lab)
• Gregory Robert Flick, M.D.
• Flight Therapy, LLC
• Michelle Rachel Fliman, MD
• Paul Warren Flint, M.D.
• Debra L Flittner, LPC
• Float North

• Behavior Technician in Portland, OR
• Providers in Portland, OR by specialty
• Behavior Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; 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.