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NPI Code Detail

MEDICARE: SARAH COOPER BCBA

MEDICARE: SARAH COOPER BCBA
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
1103K00000XBehavior AnalystABA-B-10168878OR
2103K00000XBehavior Analyst1 14 9606

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11 14 9606OTHERBEHAVIOR ANALYST CERTIFICATION BOARD
2ABA-B-10168878OTHEROROREGON HEALTH LICENSING BEHAVIOR ANALYST REGULATORY BOARD

General Provider Information

NPI Number : 1598149445
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH COOPER BCBA
Provider Business Mailing Address
First Line : 7125 SW 174TH AVE
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-6406
Country : US
Telephone Number : 503-406-8162
Fax Number :
Provider Business Practice Location Address
First Line : 7475 SW OLESON RD
Second Line :
City : PORTLAND
State : OR
Zip : 97223-7474
Country : US
Telephone Number : 971-804-0907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2015
Last Update Date : 03/27/2023

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Directions to “ SARAH COOPER BCBA” Practice Location

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