Autumn McCollum

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

912 NE Kelly Ave # 100C
Gresham, OR 97030-5629

Phone

(503) 912-5502

NPI assigned

Aug 20, 2021

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

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1578239331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913674976",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NE KELLY AVE # 100C",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305629",
            "telephone_number": "503-912-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara G McCann, MSOT
• Colin McCartney
• Jennifer McClellan
• Molly Margaret McClellan
• Junette E McColl, LMT, C.A.
• Dawn McCollum, RN
• Catherine Elizabeth McCoy, OTR/L OTD
• McCrae Management & Investments, LTD.
• Bryhanna Christinecharles McCully, PAC
• Cheryl Renee McDaniel, RDH

• Behavior Technician in Gresham, OR
• Providers in Gresham, OR by specialty
• Behavior Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.