Provider Demographics
NPI:1003156324
Name:WEST COAST BEHAVIORAL CONSULTANTS INC DBA BLUEPRINTS
Entity Type:Organization
Organization Name:WEST COAST BEHAVIORAL CONSULTANTS INC DBA BLUEPRINTS
Other - Org Name:BLUEPRINTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:206-360-0633
Mailing Address - Street 1:24 ROY STREET
Mailing Address - Street 2:#434
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109
Mailing Address - Country:US
Mailing Address - Phone:206-905-4660
Mailing Address - Fax:206-577-1101
Practice Address - Street 1:910 S. HORTON ST.
Practice Address - Street 2:UNIT 703
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134
Practice Address - Country:US
Practice Address - Phone:206-905-4660
Practice Address - Fax:206-577-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-9353103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty