NPI 1962059204 · live from the CMS NPI Registry
Patrick Boldt
Behavior Analyst in Portland, OR. National Provider Identifier 1962059204, active.
NPI record
| NPI | 1962059204 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 125 Ne 102nd Ave, Portland, OR 97220 |
| Practice phone | 032-254-6317 |
| Mailing address | 21600 Oxnard St Ste 1800, Woodland Hills, CA 91367 |
| Enumerated | August 21, 2019 |
| Last updated | August 21, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.