Active NPI
Jerrick P Obligacion
- Behavior Technician
- Auburn, WA
National Provider Identifier
1164242293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 61584201
- Practice address
- 110 2ND St SW # 140
Auburn, WA 98001-5203 - Phone
- (206) 491-5894
- NPI assigned
- Oct 14, 2024
- Last updated
- Oct 14, 2024
- Sex
- Male
- 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 | 61584201 | WA | Primary |
Addresses
Primary practice location
110 2ND St SW # 140
Auburn, WA 98001-5203
Mailing address
110 2ND St SW # 140
Auburn, WA 98001-5203
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 |
|---|---|---|---|
| 61584201 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1164242293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 2ND ST SW # 140",
"city": "AUBURN",
"state": "WA",
"postal_code": "980015203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 2ND ST SW # 140",
"city": "AUBURN",
"state": "WA",
"postal_code": "980015203",
"telephone_number": "206-491-5894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBLIGACION",
"first_name": "JERRICK",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "61584201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.