Kiddos ABA Or LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KIDDOS ABA OR LLC

Practice address

15405 SW 116TH Ave Ste 111
Portland, OR 97224-4103

Phone

(732) 604-7520

NPI assigned

Dec 8, 2025

Organization subpart

No

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

Authorized official

Name

Etty Grossman

Title

Coo

Phone

(848) 224-3500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1285597195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981227",
            "telephone_number": "732-604-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15405 SW 116TH AVE STE 111",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972244103",
            "telephone_number": "732-604-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDDOS ABA OR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-07",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "ETTY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "848-224-3500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huruy Kidane
• David Kidd, M.D.
• Matthew Sprague Kidder
• Naomi Diane Kidder, MA, LPC
• Heron Kiddle
• Kidney Care Inc
• Michael Duncan Kiefer, M.D.
• Melissa J Kieffer
• Katelyn Kiehl, QMHA
• Micah Kiehl, MD

• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.