Blue ABA Oregon LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE ABA OREGON LLC

Practice address

10260 SW Greenburg Rd Ste 400
Portland, OR 97223-5514

Phone

(786) 521-1587

NPI assigned

May 25, 2022

Organization subpart

No

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

Authorized official

Name

Gershon Fink

Title

Manager

Phone

(786) 521-1587

Specialties & licenses 1

Addresses

Tax ID family

Blue ABA Oregon LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Blue ABA Texas LLC

  • Community/Behavioral Health Agency
  • Austin, TX
  • NPI 1487304663
  NPD tax ID

Locations

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1992443220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 ALTON RD UNIT 107",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403852",
            "telephone_number": "786-521-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD STE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235514",
            "telephone_number": "786-521-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ABA OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "FINK",
        "authorized_official_first_name": "GERSHON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-521-1587"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Portland, OR
• Providers in Portland, OR by specialty
• Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.