Individual provider Active NPI

Kimberly Lynn Perras

  • Assistant Behavior Analyst
  • Port Orchard, WA
National Provider Identifier
1245010057
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
CBT.CB.61493219 Issued in WA
Practice address
3025 Seiford Ave SE
Port Orchard, WA 98366-2323
Phone
(360) 286-3295
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X CBT.CB.61493219 WA Primary

Addresses

Primary practice location

3025 Seiford Ave SE
Port Orchard, WA 98366-2323

Mailing address

3025 Seiford Ave SE
Port Orchard, WA 98366-2323
Phone (360) 286-3295

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

LicenseStateTypeSpecialty
CBT.CB.61493219WAMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1245010057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SEIFORD AVE SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662323",
            "telephone_number": "360-286-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SEIFORD AVE SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662323",
            "telephone_number": "360-286-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRAS",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "CBT.CB.61493219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.