Healthcare Provider Details

I. General information

NPI: 1780518464
Provider Name (Legal Business Name): APOLLO CALLERO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6112 GOULD AVE S
SEATTLE WA
98108-2959
US

IV. Provider business mailing address

306 BLANCHARD ST APT 306
SEATTLE WA
98121-2069
US

V. Phone/Fax

Practice location:
  • Phone: 206-659-7246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: