Individual provider Active NPI

Tina Tarver, LBA, CCC-SLP

  • Behavior Analyst
  • Redmond, WA
National Provider Identifier
1356754535
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2721 152ND Ave NE
Redmond, WA 98052-5552
Phone
(425) 429-4793
Fax
(844) 384-9206
NPI assigned
Jun 5, 2014
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL 00004760 WA
Behavior Analyst 103K00000X 607691 WA
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

2721 152ND Ave NE
Redmond, WA 98052-5552

Mailing address

1915 140TH Ave NE Ste D2146
Bellevue, WA 98005-2347
Phone (425) 429-4793

Other identifiers 1

IdentifierTypeStateIssuer
LL 00004760OtherWADEPARTMENT 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

LicenseStateTypeSpecialty
LL 00004760WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Autism Therapies, LLC Behavior Analyst Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1356754535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 140TH AVE NE STE D2146",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052347",
            "telephone_number": "425-429-4793",
            "fax_number": "844-384-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525552",
            "telephone_number": "425-429-4793",
            "fax_number": "844-384-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARVER",
        "first_name": "TINA",
        "credential": "LBA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 00004760",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "607691",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "LL 00004760",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.