Healthcare Provider Details

I. General information

NPI: 1669391942
Provider Name (Legal Business Name): AUTISM THERAPY SOLUTIONS AT PARKVIEW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S DIVISION ST
MOSES LAKE WA
98837-3800
US

IV. Provider business mailing address

615 S DIVISION ST
MOSES LAKE WA
98837-3800
US

V. Phone/Fax

Practice location:
  • Phone: 509-766-9450
  • Fax: 509-766-1954
Mailing address:
  • Phone: 509-766-9450
  • Fax: 509-766-1954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN MARIE BROSS
Title or Position: HUMAN RESOURCES
Credential:
Phone: 208-631-3677