Active NPI
Addison Marie Iverson
- Behavior Technician
- Lynnwood, WA
National Provider Identifier
1760149181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- WDL13675023B
- Practice address
- 4100 194TH St SW Ste 100
Lynnwood, WA 98036-4613 - Phone
- (425) 426-2761
- NPI assigned
- Nov 19, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | WDL13675023B | WA | Primary |
Addresses
Primary practice location
4100 194TH St SW Ste 100
Lynnwood, WA 98036-4613
Mailing address
21600 Oxnard St Ste Woodland
Woodland Hills, CA 91367-4976
Phone (818) 345-2345
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 |
|---|---|---|---|
| WDL13675023B | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1760149181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21600 OXNARD ST STE WOODLAND",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913674976",
"telephone_number": "818-345-2345",
"fax_number": "818-758-8015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 194TH ST SW STE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364613",
"telephone_number": "425-426-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVERSON",
"first_name": "ADDISON",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-19",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "WDL13675023B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.