Individual provider Active NPI

Bridgette Olsen, M. ED., BCBA, LBA

  • Behavior Analyst
  • Spokane, WA
National Provider Identifier
1528545878
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BA61243965 Issued in WA
Practice address
1722 E Sprague Ave Ste 214
Spokane, WA 99202-3109
Phone
(509) 505-9614
Fax
(509) 960-5916
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X BA61243965 WA Primary
Assistant Behavior Analyst 106E00000X AB61107164 WA

Addresses

Primary practice location

1722 E Sprague Ave Ste 214
Spokane, WA 99202-3109

Mailing address

1722 E Sprague Ave Ste 214
Spokane, WA 99202-3109
Phone (509) 505-9614

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
BA61243965WAMDBehavioral Analyst
AB61107164WAMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Olsen Behavior LLC Behavior Analyst CurrentSince Feb 13, 2022 Accepting new patients
Pennyfarthing Applied Behavior Analysis Behavior Technician PastSince Sep 23, 2021 Accepting new patients
Pennyfarthing LLC Behavior Analyst PastSince Jun 1, 2021 Accepting new patients

Locations

111 E Central Ave
Spokane, WA 99208
Phone (509) 505-9614

Organizations & group practices 3

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1528545878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 E SPRAGUE AVE STE 214",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023109",
            "telephone_number": "509-505-9614",
            "fax_number": "509-960-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 E SPRAGUE AVE STE 214",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023109",
            "telephone_number": "509-505-9614",
            "fax_number": "509-960-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "BRIDGETTE",
        "credential": "M. ED., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BA61243965",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "AB61107164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.