Individual provider Active NPI

Marisa Breanna Sterry, RBT

  • Behavior Analyst
  • Port Orchard, WA
National Provider Identifier
1063081727
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-21-167401 Issued in WA
Practice address
13765 Vintage Dr SW
Port Orchard, WA 98367-7391
Phone
(352) 233-3484
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X RBT-21-167401 WA Primary

Addresses

Primary practice location

13765 Vintage Dr SW
Port Orchard, WA 98367-7391

Mailing address

13765 Vintage Dr SW
Port Orchard, WA 98367-7391

Other practice location 1

4417 Corporation Ln Ste 350
Virginia Beach, VA 23462-3162
Phone (757) 760-3163

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

LicenseStateTypeSpecialty
RBT-21-167401WAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1063081727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13765 VINTAGE DR SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13765 VINTAGE DR SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677391",
            "telephone_number": "352-233-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4417 Corporation Ln Ste 350",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623162",
            "country_code": "US",
            "telephone_number": "757-760-3163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STERRY",
        "first_name": "MARISA",
        "middle_name": "BREANNA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "RBT-21-167401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.