Active NPI
Ara Duddlesten
- Behavior Technician
- Bend, OR
National Provider Identifier
1669049565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- ABA-IN-10213743
- Practice address
- 19800 Village Office CT Ste 104
Bend, OR 97702-1813 - Phone
- (541) 306-3483
- NPI assigned
- Jun 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | ABA-IN-10213743 | OR | Primary |
Addresses
Primary practice location
19800 Village Office CT Ste 104
Bend, OR 97702-1813
Mailing address
19800 Village Office CT Ste 104
Bend, OR 97702-1813
Phone (541) 306-3483
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ABA-IN-10213743 | OR | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Behavioral Intervention, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Bend, OR
- NPI 1942537444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1669049565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19800 VILLAGE OFFICE CT STE 104",
"city": "BEND",
"state": "OR",
"postal_code": "977021813",
"telephone_number": "541-306-3483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19800 VILLAGE OFFICE CT STE 104",
"city": "BEND",
"state": "OR",
"postal_code": "977021813",
"telephone_number": "541-306-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDDLESTEN",
"first_name": "ARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": "ABA-IN-10213743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.