Healthcare Provider Details

I. General information

NPI: 1174448336
Provider Name (Legal Business Name): ADAPTIVE BEHAVIORAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 NE MANTEL LANE
BELFAIR WA
98528
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

V. Phone/Fax

Practice location:
  • Phone: 509-213-6092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. SAMANTHA LEANNE DONALS BOEVING
Title or Position: FOUNDER
Credential: MS, BCBA, LBA
Phone: 509-213-6092