Gressa Widner

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

ABA-B-10250168 Issued in OR

Practice address

3729 Klindt Dr
The Dalles, OR 97058-3566

Phone

(541) 298-2101

Fax

(541) 298-7796

NPI assigned

Dec 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Gressa Johanson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oslc Community Programs

  • Adolescent and Children Mental Health Clinic/Center
  • Eugene, OR
  • NPI 1295747186
  NPD (past)

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1265807069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 KLINDT DR",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583566",
            "telephone_number": "541-298-2101",
            "fax_number": "541-298-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 KLINDT DR",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583566",
            "telephone_number": "541-298-2101",
            "fax_number": "541-298-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDNER",
        "first_name": "GRESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "ABA-B-10250168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRESSA",
            "last_name": "JOHANSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Nicole West, PHARMD
• Jmaes E West
• Jeffrey Joseph Westin, M.D.
• Kim Whitaker, MD
• Jason R Whitley, PHARMD
• Emma Elizabeth Wiley, LMT
• Lori Wilhite
• John D. Willer, D.O.
• Ashlyn Williams, PA-C
• Frederick Williams, LCSW

• Behavior Analyst in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.