Ryan Pebles

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

19204 N Creek Pkwy Ste 110
Bothell, WA 98011-8009

Phone

(818) 241-6780

NPI assigned

Mar 29, 2021

Last updated

Mar 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1235717612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19204 N CREEK PKWY STE 110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118009",
            "telephone_number": "818-241-6780",
            "fax_number": "818-241-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19204 N CREEK PKWY STE 110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118009",
            "telephone_number": "818-241-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEBLES",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Bothell, WA
• Providers in Bothell, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.