Provider Demographics
NPI:1588381461
Name:WEISSMAN, JULIANN
Entity type:Individual
Prefix:
First Name:JULIANN
Middle Name:
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4662 CARMAN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2530
Mailing Address - Country:US
Mailing Address - Phone:858-922-7291
Mailing Address - Fax:
Practice Address - Street 1:1091 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7042
Practice Address - Country:US
Practice Address - Phone:406-624-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-AB-10249263106E00000X
MTPSY-BA-LIC-5636103K00000X
ORABA-B-10258892103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician