NPIMap

Organization Active NPI

Imagine Behavioral and Developmental Services

  • Behavior Analyst
  • Tacoma, WA
National Provider Identifier
1043619638
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
CG60490737 Issued in WA
Legal business name
IMAGINE BEHAVIORAL AND DEVELOPMENTAL SERVICES
Practice address
9720 S Tacoma Way
Tacoma, WA 98499-4456
Phone
(253) 682-0320
NPI assigned
Aug 19, 2014
Last updated
Aug 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Nikki Pagel
Title
Credentialing
Phone
(509) 209-2696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X CG60490737 WA Primary

Addresses

Primary practice location

9720 S Tacoma Way
Tacoma, WA 98499-4456

Mailing address

901 N Monroe St Ste 200
Spokane, WA 99201-2148
Phone (509) 328-2740

National Provider Directory

National Provider Directory
Tax ID family
Imagine Behavioral and Developmental Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1043619638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-328-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S TACOMA WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984994456",
            "telephone_number": "253-682-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE BEHAVIORAL AND DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "PAGEL",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "509-209-2696"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60490737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.