Healthcare Provider Details

I. General information

NPI: 1467923482
Provider Name (Legal Business Name): MR. CORY PATRICK MAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NW 167TH PL STE 115
BEAVERTON OR
97006-4846
US

IV. Provider business mailing address

DEPT LA 22763
PASADENA CA
91185-2763
US

V. Phone/Fax

Practice location:
  • Phone: 503-836-7590
  • Fax:
Mailing address:
  • Phone: 866-523-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number10243638
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: