Shanti Nichelle Der Blatter

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

11410 NE 122ND Way
Kirkland, WA 98034-6945

Phone

(425) 650-4005

NPI assigned

Feb 3, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Roo Der Blatter Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connectionswa, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkland, WA
  • NPI 1558042234
  NPD (past)

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1275347296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BELMONT AVE E APT 905",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981026705",
            "telephone_number": "206-829-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 NE 122ND WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346945",
            "telephone_number": "425-650-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DER BLATTER",
        "first_name": "SHANTI",
        "middle_name": "NICHELLE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROO",
            "last_name": "DER BLATTER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hannah C Dentry, RDN, CD
• Ronika Depoe
• Rebecca Deputy Crofoot, LMP
• Briauna Maureen Depuy
• Thomas Gerald Depuydt, M.D.
• Diana Dericks
• Dermavita Medispa
• Dominic Desanto, DPT
• Jeremie M Descartes
• Muktai Abhay Deshpande, BDS, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.