Jacob Luke Allison

Individual provider Active NPI Behavior Technician · Gresham, OR

NPI 1720807233 · NPPES record last updated Oct 10, 2024

Key facts

NPI
1720807233
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1851 NW Civic Dr
Gresham, OR 97030-5566
Phone
(971) 292-1050
NPI assigned
Oct 10, 2024
Sex
Male
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 Yes

Addresses

Primary practice location

1851 NW Civic Dr
Gresham, OR 97030-5566

Mailing address

7500 San Felipe St Ste 990
Houston, TX 77063-1708

Other providers in Gresham, OR

All providers in Gresham, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.