Active NPI
Logan Matthew Warriner
- Behavior Technician
- Burlington, WA
National Provider Identifier
1285389239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 61124420
- Practice address
- 1838 S Burlington Blvd
Burlington, WA 98233-3226 - Phone
- (360) 972-3612
- NPI assigned
- Feb 17, 2022
- Sex
- Male
- 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 | 61124420 | WA | Primary |
Addresses
Primary practice location
1838 S Burlington Blvd
Burlington, WA 98233-3226
Mailing address
140 Ashley St Apt 306
Bellingham, WA 98229-2944
Phone (425) 753-0040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61124420 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
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 |
|---|---|---|---|
| 61124420 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1285389239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 ASHLEY ST APT 306",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982292944",
"telephone_number": "425-753-0040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1838 S BURLINGTON BLVD",
"city": "BURLINGTON",
"state": "WA",
"postal_code": "982333226",
"telephone_number": "360-972-3612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARRINER",
"first_name": "LOGAN",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-17",
"last_updated": "2022-02-17",
"certification_date": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "61124420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
"identifier": "61124420",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.