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General NPI Number Information
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NPI Number | 1598273674
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Entity Type | Individual
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Provider Name | TREVOR COAPSTICK BCBA, LBA
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Gender | Male
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 1307 4TH AVE NW
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City | PUYALLUP
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State | WA
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Zip | 98371-5133
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Country | US
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Telephone | 360-930-2898
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 SOUTH PINE STREET 505
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City | TACOMA
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State | WA
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Zip | 98409
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Country | US
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Telephone | 253-292-4354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BA61084067
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License Number State | WA
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