Takanori Koyama, BCBA-D

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA60762425 Issued in WA

Practice address

19031 33Rd Ave W Ste 101
Lynnwood, WA 98036-4722

Phone

(206) 313-8840

NPI assigned

Feb 4, 2010

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

State licenses

Practice roles

Locations

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.

• Abec LLC

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1790114593
  NPD Authorized official
• Able Pediatric Health

  • Multi-Specialty Clinic/Center
  • Tukwila, WA
  • NPI 1245728534
  NPD Authorized official

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1871825638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88083",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981382083",
            "telephone_number": "206-313-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19031 33RD AVE W STE 101",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364722",
            "telephone_number": "206-313-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 S 38th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984187807",
            "country_code": "US",
            "telephone_number": "206-313-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "651 Strander Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882914",
            "country_code": "US",
            "telephone_number": "206-313-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOYAMA",
        "first_name": "TAKANORI",
        "credential": "BCBA-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-04",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BA60762425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrey Korolev
• Andrea Korry
• Reena Anna Koshy, MD
• Kyla L Kossow
• Carole Fran Kosturn, LICSW
• Nataliya Kozak, LMP
• Lindsay Kraemer, PSY.D.
• Lisa Kraft
• Erica R Kramer, MS, RDN
• Laurie L Kreiter, MD

• Behavior Analyst in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.