Individual provider Active NPI

Emily Ann Ellis

  • Behavior Technician
  • Port Orchard, WA
National Provider Identifier
1073423083
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1605 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone
(360) 443-2399
Fax
(360) 443-6121
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X WA Primary

Addresses

Primary practice location

1605 Woodridge Dr SE
Port Orchard, WA 98366-3818

Mailing address

1605 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone (360) 443-2399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1073423083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-443-2399",
            "fax_number": "360-443-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-443-2399",
            "fax_number": "360-443-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "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 Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.