Brock O'Brien

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB60888664 Issued in WA

Practice address

651 Strander Blvd Ste 105
Tukwila, WA 98188-2914

Phone

(206) 313-8840

NPI assigned

Mar 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Able Pediatric Health

  • Multi-Specialty Clinic/Center
  • Tukwila, WA
  • NPI 1245728534
  NPD (past)

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1689209967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18207 1ST AVE S APT C4",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "981481851",
            "telephone_number": "206-403-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 STRANDER BLVD STE 105",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882914",
            "telephone_number": "206-313-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "BROCK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB60888664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111524501",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brocko@northwestaba.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "651 Strander Blvd Ste 105",
            "city": "Tukwila",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981882914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ambroise Ntumba Mbombesha
• Nurani, Mitchell, Kim, PC
• Nurturing Expressions, LLC
• Hayley Nyce
• Kenneth J O'Bara, M.D.
• Kathleen Elizabeth O'Connor
• Hilary Ann Obert, DPT
• Nathaniel Jon Obregon, RC
• Occupational Health Centers of Washington, P.S.
• Occupational Health Centers of Washington, P.S.

• Behavior Technician in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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.