Organization
WILLOW BEHAVIOR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MCCULLOUGH R CHASTAIN (CEO)
(425) 345-7114
Entity
Organization
Contact information
Practice address
4616 SW FRONTENAC ST, SEATTLE, WA 98136-1737
(425) 345-7114
Mailing address
6523 CALIFORNIA AVE SW STE 19, SEATTLE, WA 98136-1833
(425) 345-7114
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/02/2025
Last updated
07/24/2025
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