Healthcare Provider Details

I. General information

NPI: 1770082653
Provider Name (Legal Business Name): ROSE YONA NKAYAMBA BEHAVIORAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSE YONA NKAYAMBA BEHAVIORAL THERAPIST

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 216TH ST SW STE 100
MOUNTLAKE TERRACE WA
98043-2089
US

IV. Provider business mailing address

100 N HOWARD ST STE W
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 425-678-6463
  • Fax:
Mailing address:
  • Phone: 978-806-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61685043
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: