Healthcare Provider Details

I. General information

NPI: 1174441620
Provider Name (Legal Business Name): CALEB SCOTT HARGETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W DAYTON ST STE 105
EDMONDS WA
98020-7210
US

IV. Provider business mailing address

110 W DAYTON ST STE 105
EDMONDS WA
98020-7210
US

V. Phone/Fax

Practice location:
  • Phone: 206-771-8676
  • Fax: 425-589-0336
Mailing address:
  • Phone: 206-771-8676
  • Fax: 425-589-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: