Healthcare Provider Details

I. General information

NPI: 1235957648
Provider Name (Legal Business Name): ROBERT BROWN CBT, RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7808 PACIFIC AVE STE 9
TACOMA WA
98408-7062
US

IV. Provider business mailing address

7209 290TH STREET CT E
GRAHAM WA
98338-6517
US

V. Phone/Fax

Practice location:
  • Phone: 253-625-4832
  • Fax:
Mailing address:
  • Phone: 253-625-4832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-384716
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB61615519
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: