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3231 Willamette Dr Ne Ste C Lacey WA 98516-1378 | |
| (360) 970-5724 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3231 Willamette Dr Ne Ste C, Lacey, Washington |
| Authorized Official Name and Position | Heather Houskeeper (CO-OWNER) |
| Authorized Official Contact | 3609705724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3231 Willamette Dr Ne Ste C Lacey WA 98516-1378 Ph: (360) 970-5724 | 3231 Willamette Dr Ne Ste C Lacey WA 98516-1378 Ph: (360) 970-5724 |
| NPI Number | 1205409539 |
|---|---|
| Provider Enumeration Date | 07/23/2021 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205409539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 261QD1600X | Clinic/center - Developmental Disabilities | (* (Not Available)) | Secondary |
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