Active NPI
John Nicholas Ketchum, BCBA, LBA
- Behavior Analyst
- Seattle, WA
National Provider Identifier
1861842676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA61133631
- Practice address
- 1701 NE Columbia Rd
Seattle, WA 98195-0001 - Phone
- (206) 221-6806
- NPI assigned
- Jun 13, 2016
- Sex
- Male
- 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 Analyst | 103K00000X | BA61133631 | WA | Primary |
Addresses
Primary practice location
1701 NE Columbia Rd
Seattle, WA 98195-0001
Mailing address
14727 Bothell Way NE Apt 15
Shoreline, WA 98155-7621
Phone (360) 477-8322
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 |
|---|---|---|---|
| BA61133631 | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1861842676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14727 BOTHELL WAY NE APT 15",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981557621",
"telephone_number": "360-477-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 NE COLUMBIA RD",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001",
"telephone_number": "206-221-6806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHUM",
"first_name": "JOHN",
"middle_name": "NICHOLAS",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-13",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA61133631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.