Healthcare Provider Details

I. General information

NPI: 1952219362
Provider Name (Legal Business Name): ERIC M BRYAN BEHAVIOR ANALYST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3669 NE JOHN OLSEN AVE
HILLSBORO OR
97124-5815
US

IV. Provider business mailing address

3669 NE JOHN OLSEN AVE
HILLSBORO OR
97124-5815
US

V. Phone/Fax

Practice location:
  • Phone: 503-927-1179
  • Fax:
Mailing address:
  • Phone: 562-304-3705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberABA-IN-10255652
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: