Individual
KATHY REGLA TAVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19031 33RD AVE W STE 101, LYNNWOOD, WA 98036-4722
(206) 313-8840
Mailing address
708 6TH AVE N UNIT 610, SEATTLE, WA 98109-4297
(206) 900-6036
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61019190
WA
106S00000X
Behavior Technician
RBT-19-91668
HI
Other
Enumeration date
07/23/2019
Last updated
08/27/2024
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