Active NPI
Lara M Putnam
- Behavior Technician
- Dupont, WA
National Provider Identifier
1831749712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- CB60994084
- Practice address
- 1570 Wilmington Dr Ste 220
Dupont, WA 98327-8773 - Phone
- (206) 453-4882
- NPI assigned
- Sep 12, 2019
- 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 | CB60994084 | WA | Primary |
Addresses
Primary practice location
1570 Wilmington Dr Ste 220
Dupont, WA 98327-8773
Mailing address
1055 McCormick St SE
Olympia, WA 98501-2536
Phone (206) 497-0589
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 |
|---|---|---|---|
| CB60994084 | WA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Applied Behavioral Services LLC | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Spokane, WA
- NPI 1851916456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1831749712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 MCCORMICK ST SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985012536",
"telephone_number": "206-497-0589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1570 WILMINGTON DR STE 220",
"city": "DUPONT",
"state": "WA",
"postal_code": "983278773",
"telephone_number": "206-453-4882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTNAM",
"first_name": "LARA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "CB60994084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dupont, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.