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 1:2150 S COUNTRY CLUB DR STE 38
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6886
Practice Address - Country:US
Practice Address - Phone:619-795-9925
Practice Address - Fax:877-602-5087
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1-22-62768103K00000X
106S00000X
AZ001648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician