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NPI Code Detail

MEDICARE: BROOKLYN THAYER

MEDICARE: BROOKLYN THAYER
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720958317
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKLYN THAYER
Provider Business Mailing Address
First Line : 555 NW FAIRHAVEN DR
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-4480
Country : US
Telephone Number : 360-929-0145
Fax Number :
Provider Business Practice Location Address
First Line : 231 SE BARRINGTON DR STE 203
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-3200
Country : US
Telephone Number : 866-240-0808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2025
Last Update Date : 05/31/2026

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Directions to “ BROOKLYN THAYER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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