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General NPI Number Information
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NPI Number | 1609575372
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Entity Type | Individual
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Provider Name | ANNABETH LYNN PICKELL
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Gender | Female
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 33309 1ST WAY S STE 100
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6260
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Country | US
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Telephone | 253-517-5290
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Fax | 206-238-9450
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Provider Business Mailing Address
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Address Line | 4600 16TH ST E APT R202
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City | FIFE
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State | WA
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Zip | 98424-3407
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Country | US
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Telephone | 805-825-9769
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | CB61372523
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License Number State | WA
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