Provider Demographics
NPI:1225409428
Name:LUTHER, CORRIGAN ANN (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:CORRIGAN
Middle Name:ANN
Last Name:LUTHER
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18765 SW BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8496
Mailing Address - Country:US
Mailing Address - Phone:503-624-2600
Mailing Address - Fax:503-624-7752
Practice Address - Street 1:7455 SW BEVELAND RD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8610
Practice Address - Country:US
Practice Address - Phone:503-624-2600
Practice Address - Fax:503-624-7752
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0114006103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst