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NPI Code Detail

MEDICARE: KACY MAREE HYATT

MEDICARE: KACY MAREE HYATT
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 : 1871250928
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACY MAREE HYATT
Provider Business Mailing Address
First Line : 616 4TH AVE W APT 309
Second Line :
City : SEATTLE
State : WA
Zip : 98119-4408
Country : US
Telephone Number : 703-209-5390
Fax Number :
Provider Business Practice Location Address
First Line : 6112 GOULD AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98108-2959
Country : US
Telephone Number : 202-780-6475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2021
Last Update Date : 11/23/2021

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Directions to “ KACY MAREE HYATT ” Practice Location

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