Individual provider Active NPI

Tara Elizabeth Khodadadian, M.A., B.C.B.A

  • Behavior Analyst
  • Portland, OR
National Provider Identifier
1649614686
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-12936 Issued in CA
Practice address
One World Trade Center, 121 Southwest Salmon Street, 11
Portland, OR 97204-2908
Phone
(818) 371-5378
NPI assigned
Apr 22, 2013
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-12936 CA Primary

Addresses

Primary practice location

One World Trade Center, 121 Southwest Salmon Street, 11
Portland, OR 97204-2908

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1649614686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WORLD TRADE CENTER, 121 SOUTHWEST SALMON STREET, 11",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042908",
            "telephone_number": "818-371-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODADADIAN",
        "first_name": "TARA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "M.A., B.C.B.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-12936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.