Individual provider Active NPI

Jessica Coimbra, MS, BCBA, LBA, IBA

  • Behavior Analyst
  • Portland, OR
National Provider Identifier
1790254753
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-32079
Practice address
330 SE Cesar E Chavez Blvd
Portland, OR 97214-2069
Phone
(206) 580-3530
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA504 MD
Behavior Analyst 103K00000X 1-18-32079 Primary

Addresses

Primary practice location

330 SE Cesar E Chavez Blvd
Portland, OR 97214-2069

Mailing address

1728 Eastern Ave Apt 8
Baltimore, MD 21231-2452
Phone (443) 616-4170

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 Science

State licenses

LicenseStateTypeSpecialty
LBA504MDMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Neuroinclusive Contextual Behavior Coalition Behavior Analyst CurrentSince Jul 13, 2025 Accepting new patients

Locations

100 N Howard St
Spokane, WA 99201
Phone (206) 201-1163

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.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1790254753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 EASTERN AVE APT 8",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212312452",
            "telephone_number": "443-616-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142069",
            "telephone_number": "206-580-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COIMBRA",
        "first_name": "JESSICA",
        "credential": "MS, BCBA, LBA, IBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA504",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-32079",
            "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 Jul 7, 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.