NPIMap

Organization Active NPI

Sunrise ABA of Oregon LLC

  • Behavior Analyst
  • Beaverton, OR
National Provider Identifier
1851026892
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SUNRISE ABA OF OREGON LLC
Practice address
8152 SW Hall Blvd # 1090
Beaverton, OR 97008-6415
Phone
(628) 250-7500
NPI assigned
Jul 22, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Brady Keith
Title
Director of Operations
Phone
(707) 799-9527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

8152 SW Hall Blvd # 1090
Beaverton, OR 97008-6415

Mailing address

505 San Marin Dr Ste 100B
Novato, CA 94945-1309

Other practice location 1

6400 SE Lake Rd Ste 175
Portland, OR 97222-2137
Phone (628) 250-7500

National Provider Directory

National Provider Directory

Locations

8152 SW Hall Blvd
#1090
Beaverton, OR 97008

6400 SE Lake Rd
Ste 175
Portland, OR 97222
Phone (628) 587-7237

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1851026892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SAN MARIN DR STE 100B",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949451309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8152 SW HALL BLVD # 1090",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086415",
            "telephone_number": "628-250-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 SE Lake Rd Ste 175",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972222137",
            "country_code": "US",
            "telephone_number": "628-250-7500",
            "fax_number": "855-461-3566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNRISE ABA OF OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "BRADY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "707-799-9527"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.