Kanun Andrade Chacon, CBT

Individual provider Active NPI Behavior Analyst · Bellevue, WA

NPI 1780494153 · NPPES record last updated Jan 8, 2025

Key facts

NPI
1780494153
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
CB61644461 (WA)
Practice address
16120 NE 8TH St
Bellevue, WA 98008-3937
Phone
(425) 747-4004
Fax
(425) 747-1069
NPI assigned
Jan 8, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CB61644461WAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kindering Center Past
since Jan 12, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CB61644461 WA Yes

Addresses

Primary practice location

16120 NE 8TH St
Bellevue, WA 98008-3937

Mailing address

16120 NE 8TH St
Bellevue, WA 98008-3937
Phone (425) 747-4004

Other providers in Bellevue, WA

All providers in Bellevue, WA · Behavior Analyst in Washington

Sources for this page

Verify at the official NPI Registry.