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NPI Code Detail

MEDICARE: KAITLIN MARIE KLOES GREENY

MEDICARE: KAITLIN MARIE KLOES GREENY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1003152992
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN MARIE KLOES GREENY
Provider Business Mailing Address
First Line : 4746 11TH AVE NE STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4660
Country : US
Telephone Number : 206-535-8876
Fax Number :
Provider Business Practice Location Address
First Line : 4746 11TH AVE NE STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4660
Country : US
Telephone Number : 205-535-8876
Fax Number : 205-486-9938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2012
Last Update Date : 03/17/2018

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Directions to “ KAITLIN MARIE KLOES GREENY ” Practice Location

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