Mark Perry Fraidenburg

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1102 E Main
Puyallup, WA 98372-3127

Phone

(253) 339-6094

Fax

(253) 251-0716

NPI assigned

Jan 16, 2025

Last updated

Jan 16, 2025By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Behavioral Solutions, LLC

  • Community/Behavioral Health Agency
  • Puyallup, WA
  • NPI 1487114385
  NPD

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1881405124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 LILLY RD NE APT 326",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065170",
            "telephone_number": "360-986-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723127",
            "telephone_number": "253-339-6094",
            "fax_number": "253-251-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAIDENBURG",
        "first_name": "MARK",
        "middle_name": "PERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.