Healthcare Provider Details

I. General information

NPI: 1598260960
Provider Name (Legal Business Name): CARYN CROSBIE RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22526 SE 64TH PLACE BUILDING D SUITE 210
ISSAQUAH WA
98029
US

IV. Provider business mailing address

6260 139TH AVE NE APT 76
REDMOND WA
98052-9702
US

V. Phone/Fax

Practice location:
  • Phone: 425-443-2940
  • Fax:
Mailing address:
  • Phone: 425-749-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: