# CHILDREN'S BEHAVIORAL MEDICINE COLLABORATIVE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588441695
- **Authorized official:** DR. KATRINA RAYLS PH.D. (PSYCHOLOGIST)
- **Authorized official phone:** (253) 256-3626

## Contact information

- **Practice address:** 2412 N 30TH ST STE 201, TACOMA, WA 98407-6372
- **Practice address phone:** (253) 256-3626
- **Mailing address:** 2412 N 30TH ST STE 201, TACOMA, WA 98407-6372
- **Mailing address phone:** (253) 256-3626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |

## Other

- **Enumeration date:** 09/12/2023
- **Last updated:** 09/12/2023