Healthcare Provider Details

I. General information

NPI: 1578157723
Provider Name (Legal Business Name): AUTISM HEALTH PARTNERS (NW) INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 SW TUALATIN SHERWOOD RD STE 200
TUALATIN OR
97062-8620
US

IV. Provider business mailing address

8 THE GRN STE 4000
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 503-447-8770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: JASON GRAY
Title or Position: DIRECTOR
Credential:
Phone: 503-447-8770