NPIMap

Organization Active NPI

Spectra Gymnastics, LLC

Doing business as Spectra Gymnastics

  • Behavior Analyst
  • Beaverton, OR
National Provider Identifier
1598409138
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SPECTRA GYMNASTICS, LLC
Doing business as
Spectra Gymnastics
Practice address
8344 SW Nimbus Ave
Beaverton, OR 97008-6444
Phone
(503) 754-9794
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Ms. Karissa Johnson
Title
Owner
Phone
(503) 754-9794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

8344 SW Nimbus Ave
Beaverton, OR 97008-6444

Mailing address

8344 SW Nimbus Ave
Beaverton, OR 97008-6444
Phone (503) 754-9794

Other names 1

  • Spectra Gymnastics Doing business as

National Provider Directory

National Provider Directory

Locations

8344 SW Nimbus Ave
Beaverton, OR 97008
Phone (503) 754-9794

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1598409138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8344 SW NIMBUS AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086444",
            "telephone_number": "503-754-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8344 SW NIMBUS AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086444",
            "telephone_number": "503-754-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRA GYMNASTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-754-9794",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectra Gymnastics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.