| Kbm | |
|
17807 E Apollo Rd Spokane Valley WA 99016-5069 | |
| (509) 294-4622 | |
| Not Available |
| Full Name | Kbm |
|---|---|
| Speciality | Behavior Analyst |
| Location | 17807 E Apollo Rd, Spokane Valley, Washington |
| Authorized Official Name and Position | Timothy Daniel Lawson (PRESIDENT) |
| Authorized Official Contact | 5092944622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kbm 17807 E Apollo Rd Spokane Valley WA 99016-5069 Ph: (509) 294-4622 | Kbm 17807 E Apollo Rd Spokane Valley WA 99016-5069 Ph: (509) 294-4622 |
| NPI Number | 1912499112 |
|---|---|
| Provider Enumeration Date | 06/04/2018 |
| Last Update Date | 06/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912499112 | NPI | - | NPPES |
| 2076796 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | CL60621291 (Washington) | Secondary |
| 103K00000X | Behavior Analyst | BA60781563 (Washington) | Primary |
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