Healthcare Provider Details

I. General information

NPI: 1912463720
Provider Name (Legal Business Name): CHRISTINA MARCHAND BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2019
Last Update Date: 09/17/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8019 NE 13TH AVE
VANCOUVER WA
98665-9604
US

IV. Provider business mailing address

8019 NE 13TH AVE
VANCOUVER WA
98665-9604
US

V. Phone/Fax

Practice location:
  • Phone: 360-984-3131
  • Fax:
Mailing address:
  • Phone: 360-984-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61211030
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB60887155
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: