Organization
BASICS NW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW JEFFREY WOODARD BCBA (CEO)
(360) 280-4414
Entity
Organization
Contact information
Practice address
320 6TH STREET, RAYMOND, WA 98577-0859
(360) 915-6868
(360) 547-6470
Mailing address
P.O. BOX 859, RAYMOND, WA 98577-0859
(360) 915-6868
(360) 547-6470
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
CL60302030
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029980
—
WA
Enumeration date
09/20/2012
Last updated
08/05/2024
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