Individual provider Active NPI

Weston Lewis Rose

  • Behavior Analyst
  • Olympia, WA
National Provider Identifier
1679348858
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA.BA.70067559 Issued in WA
Practice address
1415 Harrison Ave NW Ste 102
Olympia, WA 98502-5359
Phone
(360) 605-0163
Fax
(855) 959-2451
NPI assigned
Nov 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA.BA.70067559 WA Primary

Addresses

Primary practice location

1415 Harrison Ave NW Ste 102
Olympia, WA 98502-5359

Mailing address

1415 Harrison Ave NW Ste 102
Olympia, WA 98502-5359
Phone (360) 605-0163

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

LicenseStateTypeSpecialty
LBA.BA.70067559WAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1679348858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HARRISON AVE NW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025359",
            "telephone_number": "360-605-0163",
            "fax_number": "855-959-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 HARRISON AVE NW STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025359",
            "telephone_number": "360-605-0163",
            "fax_number": "855-959-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "WESTON",
        "middle_name": "LEWIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "LBA.BA.70067559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.