Individual provider Active NPI

Myha McKinnon, CBT, RBT

  • Behavior Technician
  • Lakewood, WA
National Provider Identifier
1346867694
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
CB61068698 Issued in WA
Practice address
4606 108TH St SW
Lakewood, WA 98499-4146
Phone
(253) 693-2626
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X CB61068698 WA Primary

Addresses

Primary practice location

4606 108TH St SW
Lakewood, WA 98499-4146

Mailing address

PO Box 44963
Tacoma, WA 98448-0963

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
CB61068698WAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ame Higher LLC Single Specialty CurrentSince Jul 5, 2020 Accepting new patients

Locations

4606 108th St SW
Lakewood, WA 98499
Phone (253) 693-2626

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1346867694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44963",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984480963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 108TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994146",
            "telephone_number": "253-693-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "MYHA",
        "credential": "CBT, RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61068698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.