Individual provider Active NPI

Taylor Jordan Boord

  • Behavior Technician
  • Vancouver, WA
National Provider Identifier
1801370754
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
2647816 Issued in OR
Practice address
3710 NE 109TH Ave # a-02P
Vancouver, WA 98682-7764
Phone
(503) 209-7120
NPI assigned
Sep 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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
Behavior Technician 106S00000X 2647816 OR Primary

Addresses

Primary practice location

3710 NE 109TH Ave # a-02P
Vancouver, WA 98682-7764

Mailing address

3710 NE 109TH Ave # a-02P
Vancouver, WA 98682-7764
Phone (503) 209-7120

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

LicenseStateTypeSpecialty
2647816ORMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1801370754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 NE 109TH AVE # A-02P",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827764",
            "telephone_number": "503-209-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 NE 109TH AVE # A-02P",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827764",
            "telephone_number": "503-209-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOORD",
        "first_name": "TAYLOR",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "2647816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.