Individual provider Active NPI

Justin Kubat, RBT

  • Behavior Technician
  • Redmond, WA
National Provider Identifier
1265322325
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
CB61494567 Issued in WA
Practice address
2721 152ND Ave NE
Redmond, WA 98052-5552
Phone
(425) 429-4793
NPI assigned
Jul 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Technician 106S00000X CB61494567 WA Primary

Addresses

Primary practice location

2721 152ND Ave NE
Redmond, WA 98052-5552

Mailing address

2721 152ND Ave NE
Redmond, WA 98052-5552
Phone (425) 429-4793

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
CB61494567WAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1265322325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525552",
            "telephone_number": "425-429-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525552",
            "telephone_number": "425-429-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBAT",
        "first_name": "JUSTIN",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61494567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.