Isabelle Cordova

Individual provider Active NPI Behavior Technician · Portland, OR

NPI 1740034271 · NPPES record last updated Apr 12, 2024

Key facts

NPI
1740034271
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1827 NE 44TH Ave Ste 390
Portland, OR 97213-1461
Phone
(503) 963-6494
Fax
(310) 933-4134
NPI assigned
Apr 12, 2024
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Learning Network - Oregon LLC Past
since Apr 14, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1827 NE 44TH Ave Ste 390
Portland, OR 97213-1461

Mailing address

17270 SW Alexander St
Beaverton, OR 97003-4509
Phone (971) 713-4836

Other providers in Portland, OR

All providers in Portland, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.