Kristina Yvonne Vrooman, CB61025277

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB61025277 Issued in WA

Practice address

6505 218TH St SW Ste 12
Mountlake Terrace, WA 98043-2135

Phone

(360) 623-2196

NPI assigned

Dec 31, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1003455585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 218TH ST SW STE 12",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 218TH ST SW STE 12",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432135",
            "telephone_number": "360-623-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VROOMAN",
        "first_name": "KRISTINA",
        "middle_name": "YVONNE",
        "credential": "CB61025277",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61025277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.imaginebehaviorwashington.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "6505 218th St SW Ste 12",
            "city": "Mountlake Terrace",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980432135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura J Vaughan, LICSW
• Teresa GS Vazquez, LMSW
• Vision Plus of Mount Lake Terrace PLLC
• Visiting Nurse Services of the Northwest
• Celia Elizabeth Viveros, LICSW
• Darlene Grace Wagler, LMHCA
• Alexis Michael Walker
• Grant Walker, PHARM.D.
• Elizabeth Rachel Wallace, MFT
• Jamie Wallace

• Behavior Technician in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.