Healthcare Provider Details

I. General information

NPI: 1598354136
Provider Name (Legal Business Name): ERIN LANDIS BURKETT BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19203 38TH AVE SE
BOTHELL WA
98012-7852
US

IV. Provider business mailing address

19203 38TH AVE SE
BOTHELL WA
98012-7852
US

V. Phone/Fax

Practice location:
  • Phone: 904-521-7732
  • Fax:
Mailing address:
  • Phone: 904-521-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number61387469
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61497383
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: