MEDICARE: KATHRYN STEWART 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	BA60777150	WA
2	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1508250242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN STEWART BCBA, LBA

Provider Business Mailing Address
First Line	:	5417 96TH AVENUE CT NW
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-6094
Country	:	US
Telephone Number	:	253-370-4780
Fax Number	:

Provider Business Practice Location Address
First Line	:	6523 CALIFORNIA AVE SW STE 19
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1833
Country	:	US
Telephone Number	:	253-370-4780
Fax Number	:

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

Provider Enumeration Date	:	03/19/2015
Last Update Date	:	02/10/2026

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