Individual provider Active NPI

Jessica Laryea, RBAI

  • Behavior Technician
  • Portland, OR
National Provider Identifier
1972484996
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
ABA-IN-10258491 Issued in OR
Practice address
7133 N Lombard St Ste 104
Portland, OR 97203-3205
Phone
(971) 420-7372
Fax
(503) 850-7602
NPI assigned
Sep 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X ABA-IN-10258491 OR Primary

Addresses

Primary practice location

7133 N Lombard St Ste 104
Portland, OR 97203-3205

Mailing address

7133 N Lombard St Ste 104
Portland, OR 97203-3205
Phone (971) 420-7372

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
ABA-IN-10258491ORMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1972484996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7133 N LOMBARD ST STE 104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033205",
            "telephone_number": "971-420-7372",
            "fax_number": "503-850-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7133 N LOMBARD ST STE 104",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033205",
            "telephone_number": "971-420-7372",
            "fax_number": "503-850-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARYEA",
        "first_name": "JESSICA",
        "credential": "RBAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "ABA-IN-10258491",
            "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 Sep 8, 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.