Healthcare Provider Details

I. General information

NPI: 1588381461
Provider Name (Legal Business Name): JULIANN WEISSMAN MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 SW CASCADE AVE STE 200
BEAVERTON OR
97008-7496
US

IV. Provider business mailing address

8585 SW CASCADE AVE STE 200
BEAVERTON OR
97008-7496
US

V. Phone/Fax

Practice location:
  • Phone: 503-839-9401
  • Fax:
Mailing address:
  • Phone: 503-839-9401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberABA-AB-10249263
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberABA-B-10258892
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPSY-BA-LIC-5636
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: