Elliott Anderson, BCBA

Individual provider Active NPI Behavior Analyst · Portland, OR

NPI 1609533173 · NPPES record last updated Feb 3, 2026

Key facts

NPI
1609533173
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
12155668 (SC)
Practice address
One World Trade Center
121 Southwest Salmon Street, 11TH Floor
Portland, OR 97204-0000
Phone
(855) 832-6727
Fax
(772) 675-9100
NPI assigned
Nov 19, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12155668SCMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12155668 SC Yes

Addresses

Primary practice location

One World Trade Center
121 Southwest Salmon Street, 11TH Floor
Portland, OR 97204-0000

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

Other providers in Portland, OR

All providers in Portland, OR · Behavior Analyst in Oregon

Sources for this page

Verify at the official NPI Registry.