MEDICARE: MR. RALPH NICHOLAS PAMPINO JR. MA, BCBA, LBA

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
1	103K00000X	Behavior Analyst	1041648

General Provider Information

NPI Number	:	1023339934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RALPH NICHOLAS PAMPINO JR. MA, BCBA, LBA

Provider Business Mailing Address
First Line	:	3213 W WHEELER ST # 302
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3245
Country	:	US
Telephone Number	:	425-422-5521
Fax Number	:

Provider Business Practice Location Address
First Line	:	3213 W WHEELER ST # 302
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3245
Country	:	US
Telephone Number	:	425-422-5521
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	05/16/2024

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