Kellan Pontarolo

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

888 Western Avenue Apt. 815
Seattle, WA 98104

Phone

(307) 532-1946

NPI assigned

Jan 21, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1174980163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WESTERN AVE APT 815",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 WESTERN AVENUE APT. 815",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98104",
            "telephone_number": "307-532-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTAROLO",
        "first_name": "KELLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Pong, PHARM D
• Ryan P Pong, MD
• Stephen Y Pong, DDS
• Lauren Poniatowski, MD, MS
• Tanya Sajan Ponnatt, MD
• Jason Pool
• Sara Frances Pool, SLP-CCC
• Carol Jean Poole, MA, LMHC
• Dacotah Poole
• Jeanne E Poole, MD

• Behavior Analyst in Seattle, WA
• Providers in Seattle, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.