Healthcare Provider Details

I. General information

NPI: 1902253388
Provider Name (Legal Business Name): THE BEHAVIOR PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18422 103RD AVE NE
BOTHELL WA
98011-3410
US

IV. Provider business mailing address

3810 166TH PL NE STE 202B
ARLINGTON WA
98223-8403
US

V. Phone/Fax

Practice location:
  • Phone: 425-949-0801
  • Fax: 866-764-2841
Mailing address:
  • Phone: 425-949-0801
  • Fax: 866-764-2841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA TREST
Title or Position: OWNER
Credential:
Phone: 571-970-7703