Active NPI
Junne Y Park, BCABA
- Behavior Analyst
- Bremerton, WA
National Provider Identifier
1174861173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0-11-4287
- Practice address
- 155 NE Fairgrounds Rd
#15
Bremerton, WA 98311-8851 - Phone
- (808) 391-1295
- NPI assigned
- Jan 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | 0-11-4287 | Primary |
Addresses
Primary practice location
155 NE Fairgrounds Rd
#15
Bremerton, WA 98311-8851
Mailing address
155 NE Fairgrounds Road
#15
Bremerton, WA 98311
Phone (808) 391-1295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0-11-4287 | Other | BEHAVIOR ANALYST CERTIFICATION BOARD |
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": "1359072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359072000000",
"number": "1174861173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 NE FAIRGROUNDS ROAD",
"address_2": "#15",
"city": "BREMERTON",
"state": "WA",
"postal_code": "98311",
"telephone_number": "808-391-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 NE FAIRGROUNDS RD",
"address_2": "#15",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118851",
"telephone_number": "808-391-1295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JUNNE",
"middle_name": "Y",
"credential": "BCABA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-25",
"last_updated": "2013-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "0-11-4287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
"identifier": "0-11-4287",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.