Individual provider Active NPI

Olivia Madison Tung, CBT

  • Behavior Technician
  • Federal Way, WA
National Provider Identifier
1346921731
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
CB61338893 Issued in WA
Practice address
1641 S 370TH PL
Federal Way, WA 98003-7587
Phone
(206) 257-8983
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X CB61338893 WA Primary

Addresses

Primary practice location

1641 S 370TH PL
Federal Way, WA 98003-7587

Mailing address

1641 S 370TH PL
Federal Way, WA 98003-7587
Phone (206) 257-8983

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL securerecords.sanford.html Maxim Healthcare Services, Inc.

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
CB61338893WAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1346921731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 S 370TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037587",
            "telephone_number": "206-257-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 S 370TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037587",
            "telephone_number": "206-257-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "OLIVIA",
        "middle_name": "MADISON",
        "credential": "CBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61338893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "affiliationName": "Maxim Healthcare Services, Inc.",
            "address_1": "1641 S 370th Pl",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980037587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.