Tristan Penn

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

5415 SE Milwaukie Ave
Portland, OR 97202-4940

Phone

(785) 764-4374

NPI assigned

Jun 16, 2015

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

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1518348515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18670 SW BOONES FERRY RD APT 26",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628489",
            "telephone_number": "785-764-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972024940",
            "telephone_number": "785-764-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "TRISTAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Penman, AUD
• Barbara N. Penn, M.A., QMHP
• Melissa Renee Penn, C.D.A. - E.F.D.A.
• Morgan Penn, PT
• Regan Ann Penn
• Floyd Martin Penna, LPC, CADC III, CSAT
• Jason Pennell, PHARMD
• Olivia L Pennelle, MSW, CWSA
• Ashley Penner, AU.D.
• Aubra Danielle Penner

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.