Active NPI
Kirby Siemens, BCBA
- Behavior Analyst
- Beaverton, OR
National Provider Identifier
1255955480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA61420154
- Practice address
- 1800 NW 167TH PL Ste 115
Beaverton, OR 97006-4846 - Phone
- (855) 772-8847
- NPI assigned
- Jun 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | BA61420154 | CA | Primary |
Addresses
Primary practice location
1800 NW 167TH PL Ste 115
Beaverton, OR 97006-4846
Mailing address
4842 Brighton Ave
San Diego, CA 92107-2518
Phone (530) 333-7150
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BA61420154 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Formations Behavior Therapy | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1326546235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1255955480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4842 BRIGHTON AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921072518",
"telephone_number": "530-333-7150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 NW 167TH PL STE 115",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970064846",
"telephone_number": "855-772-8847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEMENS",
"first_name": "KIRBY",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-03",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "BA61420154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.