Active NPI
Laura Marjorie Ottum
- Behavior Technician
- Walla Walla, WA
National Provider Identifier
1295528347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- CBT.CB.70004076
- Practice address
- 106 S 2ND Ave
Walla Walla, WA 99362-3001 - Phone
- (408) 409-3517
- NPI assigned
- May 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | CBT.CB.70004076 | WA | Primary |
Addresses
Primary practice location
106 S 2ND Ave
Walla Walla, WA 99362-3001
Mailing address
602 Boyer Ave Apt I3
Walla Walla, WA 99362-2366
Phone (408) 409-3517
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 |
|---|---|---|---|
| CBT.CB.70004076 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1295528347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 BOYER AVE APT I3",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622366",
"telephone_number": "408-409-3517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 S 2ND AVE",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993623001",
"telephone_number": "408-409-3517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTUM",
"first_name": "LAURA",
"middle_name": "MARJORIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "CBT.CB.70004076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.