Camille Petrich

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

18765 SW Boones Ferry Rd
Tualatin, OR 97062-8496

Phone

(503) 612-1000

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1598336869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11865 SW TUALATIN RD APT 172",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627076",
            "telephone_number": "515-460-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18765 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628496",
            "telephone_number": "503-612-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICH",
        "first_name": "CAMILLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2025-04-02",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "ABA-IN-10215441",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace L Peterson, DMD
• Dean Kyle Peterson, MD
• Heather Wehling Peterson
• Jenna Peterson, M.D.
• Nancy Petit
• Steven Scott Pettigrew, DC PC
• Catherine Pettit, PT
• Lisa C Pew, MD
• Ian Pham, DMD
• Ashley Phillips, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.