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910 S. Horton St. Unit 703 Seattle WA 98134 | |
| (206) 905-4660 | |
| (206) 577-1101 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 910 S. Horton St., Seattle, Washington |
| Authorized Official Name and Position | Shane David Isley (CEO/PRESIDENT) |
| Authorized Official Contact | 2063600633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
24 Roy Street #434 Seattle WA 98109 Ph: (206) 905-4660 | 910 S. Horton St. Unit 703 Seattle WA 98134 Ph: (206) 905-4660 |
| NPI Number | 1003156324 |
|---|---|
| Provider Enumeration Date | 02/22/2013 |
| Last Update Date | 11/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003156324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-11-9353 (* (Not Available)) | Primary |
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