Healthcare Provider Details

I. General information

NPI: 1083393342
Provider Name (Legal Business Name): KIARA DANIELLE ZMIAROVICH SADAYA CBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 130TH AVE NE STE 100
BELLEVUE WA
98005-1757
US

IV. Provider business mailing address

2310 130TH AVE NE STE 100
BELLEVUE WA
98005-1757
US

V. Phone/Fax

Practice location:
  • Phone: 425-882-8868
  • Fax: 425-633-2282
Mailing address:
  • Phone: 425-882-8868
  • Fax: 425-633-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number61458600
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: