Provider Demographics
NPI:1386926442
Name:KLESS, DIANA (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:KLESS
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9658 SW EVERETT TER
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5456
Mailing Address - Country:US
Mailing Address - Phone:310-864-1594
Mailing Address - Fax:
Practice Address - Street 1:10260 SW GREENBURG RD FL 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5500
Practice Address - Country:US
Practice Address - Phone:310-865-0800
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst