Active NPI
Amanda Polk
- Behavior Analyst
- Portland, OR
National Provider Identifier
1942740873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-44657
- Practice address
- One World Trade Center, 121 Southwest Salmon Street
11TH Floor
Portland, OR 97204-0000 - Phone
- (855) 832-6727
- NPI assigned
- Feb 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-44657 | NC | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
One World Trade Center, 121 Southwest Salmon Street
11TH Floor
Portland, OR 97204-0000
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1942740873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE WORLD TRADE CENTER, 121 SOUTHWEST SALMON STREET",
"address_2": "11TH FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972040000",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-24",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NC",
"license": "1-20-44657",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"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 Nov 17, 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.