Active NPI
Michaela Russ
- Behavior Analyst
- Lakewood, WA
National Provider Identifier
1588166953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-47561
- Practice address
- 5919 100TH St SW # 2
Lakewood, WA 98499-2731 - Phone
- (855) 223-7123
- Fax
- (619) 374-7134
- NPI assigned
- Mar 1, 2018
- Last updated
- Oct 1, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BA61148429 | WA | |
| Behavior Analyst | 103K00000X | 1-21-47561 | WA | Primary |
Addresses
Primary practice location
5919 100TH St SW # 2
Lakewood, WA 98499-2731
Mailing address
PO Box 740780
Atlanta, GA 30374-0780
Phone (855) 223-7123
Other practice location 1
10015 Lakewood Dr SW
Lakewood, WA 98499-3838
Phone (253) 358-0888
Other practice location 2
521 Military Rd S
Tacoma, WA 98444-2600
Phone (855) 223-7123
Other names 1
- Michaela Rehm
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 |
|---|---|---|---|
| BA61148429 | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790812800000",
"number": "1588166953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 740780",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303740780",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5919 100TH ST SW # 2",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992731",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
}
],
"practiceLocations": [
{
"address_1": "10015 Lakewood Dr SW",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "WA",
"postal_code": "984993838",
"country_code": "US",
"telephone_number": "253-358-0888",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "521 Military Rd S",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984442600",
"country_code": "US",
"telephone_number": "855-223-7123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSS",
"first_name": "MICHAELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-01",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA61148429",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "1-21-47561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHAELA",
"last_name": "REHM",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.