Active NPI
Kathleen Spear
- Behavior Technician
- Silverdale, WA
National Provider Identifier
1053797001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- CB60762132
- Practice address
- 3100 NW Bucklin Hill Rd
Suite 224
Silverdale, WA 98383-8358 - Phone
- (360) 536-3060
- Fax
- (347) 823-9717
- NPI assigned
- Jul 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CB60762132 | WA | Primary |
Addresses
Primary practice location
3100 NW Bucklin Hill Rd
Suite 224
Silverdale, WA 98383-8358
Mailing address
5112 NW Taylor Rd
Bremerton, WA 98312-8837
Phone (360) 373-2536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CB60762132 | WA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holly Ridge Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Physical Therapist
- Bremerton, WA
- NPI 1861549206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1053797001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5112 NW TAYLOR RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983128837",
"telephone_number": "360-373-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 NW BUCKLIN HILL RD",
"address_2": "SUITE 224",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838358",
"telephone_number": "360-536-3060",
"fax_number": "347-823-9717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAR",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-31",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "CB60762132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
- Sound Pain Alliance (Peninsula Pain Clinic)
- Sound Pain Alliance (Peninsula Pain Clinic)
- Sound Speech & Language, PLLC
- South Sound Inpatient Physicians, PLLC
- Natalie Souza, AU.D.
- Katelyn Marie Spencer, PA-C
- Michelle Spencer, LMP
- David J Spinak, MD
- Jesse Hope Spivack, MS, CN, LMHC
- Ashley Marie Spletstoeser, LMP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.