NPIMap

Organization Active NPI

Basics NW LLC

  • Behavior Analyst
  • Raymond, WA
National Provider Identifier
1073864849
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BASICS NW LLC
Practice address
320 6TH Street
Raymond, WA 98577-0859
Phone
(360) 915-6868
Fax
(360) 547-6470
NPI assigned
Sep 20, 2012
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Mr. Matthew Jeffrey Woodard, BCBANPI 1205142825
Title
Ceo
Phone
(360) 280-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Community/Behavioral Health Agency 251S00000X CL60302030 WA

Addresses

Primary practice location

320 6TH Street
Raymond, WA 98577-0859

Mailing address

P.O. Box 859
Raymond, WA 98577-0859
Phone (360) 915-6868

Other identifiers 1

IdentifierTypeStateIssuer
2029980MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Basics Northwest2 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.

Locations

320 6th St
Raymond, WA 98577
Phone (360) 280-4414

1890 Barnes Blvd SW
Tumwater, WA 98512

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1073864849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 859",
            "city": "RAYMOND",
            "state": "WA",
            "postal_code": "985770859",
            "telephone_number": "360-915-6868",
            "fax_number": "360-547-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 6TH STREET",
            "city": "RAYMOND",
            "state": "WA",
            "postal_code": "985770859",
            "telephone_number": "360-915-6868",
            "fax_number": "360-547-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASICS NW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-280-4414",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "CL60302030",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029980",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.