Cody Alan Black

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1003 7TH Ave
Kirkland, WA 98033-5779

Phone

(142) 565-8301

NPI assigned

Feb 20, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1740045533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W CASINO RD APT Y205",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048101",
            "telephone_number": "253-258-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 7TH AVE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980335779",
            "telephone_number": "142-565-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CODY",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Jon Bittner, MD
• Jacob Bivans
• Kory Bizal
• Jacob Bjork
• Victoria Black Horse, M.D.
• Jaishaun Black
• Marissa Black, M.D.
• Olivia Christine Blackshie
• Tennille Kelsey Blair, N.D.
• Blake Davis PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.