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NPI Code Detail

MEDICARE: KELSIE MCQUEEN-GERHART

MEDICARE: KELSIE MCQUEEN-GERHART
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 Analyst1-21-52724WA
2103K00000XBehavior Analyst1-21-52724CA
3106E00000XAssistant Behavior Analyst0167537CA

General Provider Information

NPI Number : 1861905069
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE MCQUEEN-GERHART
Provider Business Mailing Address
First Line : 1314 AUBURN WAY N
Second Line :
City : AUBURN
State : WA
Zip : 98002-4109
Country : US
Telephone Number : 253-237-3405
Fax Number : 253-426-3096
Provider Business Practice Location Address
First Line : 1314 AUBURN WAY N
Second Line :
City : AUBURN
State : WA
Zip : 98002-4109
Country : US
Telephone Number : 253-237-3405
Fax Number : 253-426-3096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2017
Last Update Date : 01/25/2026

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Directions to “ KELSIE MCQUEEN-GERHART ” Practice Location

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