Provider Demographics
NPI:1104362698
Name:TASSON, COURTNEY (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TASSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:C
Other - Last Name:GRUENSFELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:61560 AARON WAY APT 6203
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9407
Mailing Address - Country:US
Mailing Address - Phone:682-478-9711
Mailing Address - Fax:
Practice Address - Street 1:121 SW SALMON ST FL 11
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-2908
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst