Individual
PAYTON WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008
(971) 200-1966
Mailing address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
1018863
OR
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871007872
—
OR
Enumeration date
11/29/2017
Last updated
03/17/2025
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