Healthcare Provider Details

I. General information

NPI: 1780331843
Provider Name (Legal Business Name): CLARISSA FE RAMBAYON O'FRANCIA CBT, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24120 VAN RY BLVD STE 400
MOUNTLAKE TERRACE WA
98043-5459
US

IV. Provider business mailing address

950 BROADWAY STE 301
TACOMA WA
98402-4454
US

V. Phone/Fax

Practice location:
  • Phone: 425-245-9940
  • Fax:
Mailing address:
  • Phone: 253-292-4354
  • Fax: 855-373-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB61369521
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB61026627
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: