JORDAN K SMITH (NPI# 1477037851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477037851 |
| Entity Type | Individual |
| Full Name | JORDAN K SMITH |
| Practice Address |
912 Ne Kelly Ave Ste 100 Gresham OR 97030-5631 |
| Practice Telephone | 5039125502 |
| Mailing Telephone | 5039125502 |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2018-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212751 | Jordan C Smith | Pharmacist | 105 W 8th Ave # 350e, Spokane, WA 99204-2302 | 2020-07-08 |
| 1841816105 | Jordan Smith | Specialist/Technologist, Other | 7101 Bryant Irvin Rd Unit 34506, Fort Worth, TX 76162-5009 | 2020-06-23 |
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1447815816 | Jordan Nichole Smith | Student in an Organized Health Care Education/Training Program | 4061 Idewild Loop # D403, Coeur D Alene, ID 83814-7091 | 2019-05-01 |
| 1447734579 | Jordan Smith | Hearing Instrument Specialist | 843 W Summit Ave, Muskegon, MI 49441-4047 | 2018-09-25 |
| 1477055366 | Jordan A Smith | Chiropractor | 7604 Ne 5th Ave Ste 109, Vancouver, WA 98665-8200 | 2018-03-06 |
| 1235656919 | Jordan Smith | Licensed Practical Nurse | 3957 Dean Rd, Marion, NY 14505 | 2017-08-24 |
| 1407171606 | Jordan D Smith | Pharmacist | 4 Long Cove Ct, Greensboro, NC 27407-5843 | 2010-03-30 |
| 1225292139 | Jordan D Smith | Optometrist | 1205 Old Highway 127 S, Jamestown, TN 38556-5609 | 2008-07-10 |
| 1013514553 | Jordan Claire Smith | Nurse Practitioner | 2550 Flowood Dr Ste 300, Flowood, MS 39232-9306 | 2020-10-07 |
| Street Address |
912 NE KELLY AVE STE 100 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-5631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609370501 | Delia Yulisa Ruiz | Behavior Technician | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2018-03-23 |
| 1316581291 | Shea Marie Gowdy | Behavioral Analyst | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2019-11-04 |
| 1285196527 | Kiasha Causey | Behavioral Analyst | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2019-04-04 |
| 1922588987 | Elizabeth Lea Lewis | Behavior Technician | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2018-08-20 |
| 1851884514 | Connor Jones | Behavioral Analyst | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2018-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366937609 | Chelsea Ashley Dryer | Behavior Technician | 912 Ne Kelly Ave Ste 100c, Gresham, OR 97030-5629 | 2018-06-28 |
| 1154812139 | Megan Mercedes Cooper | Behavior Technician | 912 Ne Kelly Ave # 100c, Gresham, OR 97030-5629 | 2018-05-24 |
| 1609370501 | Delia Yulisa Ruiz | Behavior Technician | 912 Ne Kelly Ave Ste 100, Gresham, OR 97030-5631 | 2018-03-23 |
| 1639786098 | Bailey Ritschard | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-09-29 |
| 1245847615 | Samantha Overton | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-09-29 |
| 1477160943 | Madison Limon | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-09-28 |
| 1750994604 | Summer Barraza | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-08-28 |
| 1992318844 | Ashly Rincon | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-08-28 |
| 1518591734 | Breck Butler | Behavior Technician | 1851 Nw Civic Dr, Gresham, OR 97030-5566 | 2020-02-26 |
| 1689208225 | Liliana Marie Moore Lopez | Behavior Technician | 912 Ne Kelly Ave # 100c, Gresham, OR 97030-5629 | 2020-02-22 |
| Find all providers in GRESHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.