Provider Demographics
NPI:1790323038
Name:WEATHERILL, ASHLEY (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:WEATHERILL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7140 SW FIR LOOP STE 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8062
Mailing Address - Country:US
Mailing Address - Phone:971-249-3791
Mailing Address - Fax:
Practice Address - Street 1:7140 SW FIR LOOP STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8062
Practice Address - Country:US
Practice Address - Phone:971-249-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1-22-62768103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician