Kathryn E Allen

Individual provider Active NPI Behavior Technician · Gresham, OR

NPI 1639634249 · NPPES record last updated Feb 7, 2019

Key facts

NPI
1639634249
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
912 NE Kelly Ave
Gresham, OR 97030-5629
Phone
(503) 912-5502
Fax
(503) 912-5502
NPI assigned
Feb 7, 2019
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X OR Yes

Addresses

Primary practice location

912 NE Kelly Ave
Gresham, OR 97030-5629

Mailing address

912 NE Kelly Ave
Gresham, OR 97030-5629
Phone (503) 912-5502

Other practice location 1

912 NE Kelly Ave
Gresham, OR 97030-5629
Phone (503) 912-5502

Other providers in Gresham, OR

All providers in Gresham, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.