Active NPI
Jessica A Schenck
- Behavior Technician
- Lacey, WA
National Provider Identifier
1215777487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- CB61561692
- Practice address
- 3231 Willamette Dr NE Ste a
Lacey, WA 98516-1378 - Phone
- (360) 878-6434
- NPI assigned
- May 27, 2024
- Sex
- Female
- 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 | CB61561692 | WA | Primary |
Addresses
Primary practice location
3231 Willamette Dr NE Ste a
Lacey, WA 98516-1378
Mailing address
7756 Sawgrass LN SE
Lacey, WA 98503-4616
Phone (470) 535-6775
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 |
|---|---|---|---|
| CB61561692 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716768000000",
"number": "1215777487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7756 SAWGRASS LN SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985034616",
"telephone_number": "470-535-6775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3231 WILLAMETTE DR NE STE A",
"city": "LACEY",
"state": "WA",
"postal_code": "985161378",
"telephone_number": "360-878-6434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHENCK",
"first_name": "JESSICA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-27",
"last_updated": "2024-05-27",
"certification_date": "2024-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "CB61561692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.