Active NPI
Tina Tarver, LBA, CCC-SLP
- Behavior Analyst
- Redmond, WA
National Provider Identifier
1356754535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- 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, 2026
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL 00004760 | Other | WA | 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 |
|---|---|---|---|
| LL 00004760 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Behavior Analyst
- Redmond, WA
- NPI 1255865135
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.