Katie Arleen Spicer

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-23447 Issued in OR

Practice address

412 Jefferson Pkwy Ste 202
Lake Oswego, OR 97035-1252

Phone

(888) 428-3223

Fax

(323) 866-1881

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katie Arleen Peterson Former name

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1568810414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 300A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103537",
            "telephone_number": "888-428-3223",
            "fax_number": "323-866-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 JEFFERSON PKWY STE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351252",
            "telephone_number": "888-428-3223",
            "fax_number": "323-866-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "KATIE",
        "middle_name": "ARLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "1-16-23447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "PETERSON",
            "middle_name": "ARLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Lake Oswego, OR
• Providers in Lake Oswego, 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 26, 2020; 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.