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NPI Code Detail

MEDICARE: MIKAYLA NICOLE TEMPLE RBT

MEDICARE: MIKAYLA NICOLE TEMPLE RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1891274023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA NICOLE TEMPLE RBT
Provider Business Mailing Address
First Line : 5457 SW CANYON CT
Second Line :
City : PORTLAND
State : OR
Zip : 97221-2401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5457 SW CANYON CT
Second Line :
City : PORTLAND
State : OR
Zip : 97221-2401
Country : US
Telephone Number : 971-762-4663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 11/10/2023

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Directions to “ MIKAYLA NICOLE TEMPLE RBT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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