ABA of Portland Corp.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ABA OF PORTLAND CORP.

Practice address

11304 SE 35TH Ave
Milwaukie, OR 97222-6764

Phone

(786) 569-3941

Fax

(888) 391-5328

NPI assigned

Feb 21, 2019

Last updated

Feb 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Igor Ernesto Bruzual

Title

President

Phone

(786) 569-3941

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1336606755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11304 SE 35TH AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226764",
            "telephone_number": "786-569-3941",
            "fax_number": "888-391-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11304 SE 35TH AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226764",
            "telephone_number": "786-569-3941",
            "fax_number": "888-391-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA OF PORTLAND CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "BRUZUAL",
        "authorized_official_first_name": "IGOR",
        "authorized_official_middle_name": "ERNESTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-569-3941"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.