Individual provider Active NPI

Alisa Michelle Wilson-Coleman

  • Behavior Analyst
  • Tigard, OR
National Provider Identifier
1851867154
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7278236 Issued in OR
Practice address
15290 SW Royalty Pkwy
Tigard, OR 97224-4059
Phone
(971) 256-4050
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 7278236 OR Primary

Addresses

Primary practice location

15290 SW Royalty Pkwy
Tigard, OR 97224-4059

Mailing address

15290 SW Royalty Pkwy # 300
Tigard, OR 97224-4059
Phone (971) 256-4050

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
7278236ORMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1851867154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15290 SW ROYALTY PKWY # 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972244059",
            "telephone_number": "971-256-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15290 SW ROYALTY PKWY",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972244059",
            "telephone_number": "971-256-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-COLEMAN",
        "first_name": "ALISA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "7278236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.