Erik M Mendiola

Key facts

NPI

1396360301

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

Practice address

223 W I St
Shelton, WA 98584-2923

Phone

(360) 463-7065

NPI assigned

Jun 15, 2020

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 15, 2020.

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1396360301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 W I ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842923",
            "telephone_number": "360-463-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W I ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842923",
            "telephone_number": "360-463-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "ERIK",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

• Aditya Mehta, M.D.
• Eric Andrew Melody, MPT
• Ezekiel Derek Alexander Melquist, MD
• Heather Liv Melver, MSW, LSWAIC
• Jesus Danny Mendiola-Lopez
• Mental Health Professionals, LLC
• Larry Messenger, PT
• Michelle Lynn Messenger, LMP
• Stephanie Messier
• Michael Ge Thomas

All providers in Shelton, WA · Behavior Analyst in Washington