Ana Georgina Acosta
Individual provider Active NPI Behavior Analyst · Gresham, OR
NPI 1992338677 · NPPES record last updated Feb 20, 2020
Key facts
- NPI
- 1992338677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 912 NE Kelly Ave # 100C
Gresham, OR 97030-5629 - Phone
- (503) 912-5502
- NPI assigned
- Feb 20, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
912 NE Kelly Ave # 100C
Gresham, OR 97030-5629
Mailing address
14213 SE Center St
Portland, OR 97236-2741
Phone (971) 712-8711
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.