Individual provider Active NPI

Nina Bullard

  • Behavior Analyst
  • Puyallup, WA
National Provider Identifier
1104218031
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
15406 Meridian E Ste 103
Puyallup, WA 98375-9504
Phone
(253) 262-3409
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X WA
Behavior Analyst 103K00000X WA Primary

Addresses

Primary practice location

15406 Meridian E Ste 103
Puyallup, WA 98375-9504

Mailing address

15406 Meridian E Ste 103
Puyallup, WA 98375-9504

Other practice location 1

3214 W McGraw St Ste 212
Seattle, WA 98199-3239
Phone (888) 294-1118

Other practice location 2

8815 S Tacoma Way Ste 122
Tacoma, WA 98499-7011
Phone (206) 388-0544

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

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1104218031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15406 MERIDIAN E STE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983759504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15406 MERIDIAN E STE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983759504",
            "telephone_number": "253-262-3409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3214 W McGraw St Ste 212",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981993239",
            "country_code": "US",
            "telephone_number": "888-294-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8815 S Tacoma Way Ste 122",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984997011",
            "country_code": "US",
            "telephone_number": "206-388-0544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.