Mikayla Willis

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB61216057 Issued in WA

Practice address

851 SE Pioneer Way Ste 201
Oak Harbor, WA 98277-5789

Phone

(360) 972-3612

NPI assigned

Jul 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1669200044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 32ND ST UNIT A309",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982256924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 SE PIONEER WAY STE 201",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775789",
            "telephone_number": "360-972-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MIKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB61216057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.bluewateraba.com",
            "affiliation": "N",
            "address_1": "851 SE Pioneer Way Ste 201",
            "city": "Oak Harbor",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982775789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Eric Williams, M.D.
• Paul Marcel Williams
• Robert M Williams, PT
• Scott Hyde Williams, O.D.
• Rachael Williamson, RBT
• Allyson Noelle Willson
• Carly N Wilson
• Nellie Wilson, LMT, LMP
• Derek Thomas Wirth, DMD
• Douglas Lee Wirth, DMD

• Behavior Technician in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.