Active NPI
Jessica Lake
- Behavior Technician
- Bellevue, WA
National Provider Identifier
1962938274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 14434 NE 8TH St
300
Bellevue, WA 98007-4146 - Phone
- (425) 502-5060
- NPI assigned
- May 5, 2017
- 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 | Primary |
Addresses
Primary practice location
14434 NE 8TH St
300
Bellevue, WA 98007-4146
Mailing address
711 W Casino Rd
6B4
Everett, WA 98204-1657
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-16-22011 | Other | BACB |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1962938274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W CASINO RD",
"address_2": "6B4",
"city": "EVERETT",
"state": "WA",
"postal_code": "982041657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14434 NE 8TH ST",
"address_2": "300",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980074146",
"telephone_number": "425-502-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-05",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT-16-22011",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.