Provider Demographics
NPI:1073391108
Name:AUTISM SERVICES OF WASHINGTON
Entity Type:Organization
Organization Name:AUTISM SERVICES OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:SHEILA
Authorized Official - Last Name:WAMBUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-391-4602
Mailing Address - Street 1:2100 S 285TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3319
Mailing Address - Country:US
Mailing Address - Phone:253-455-2957
Mailing Address - Fax:253-322-0169
Practice Address - Street 1:2100 S 285TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-3319
Practice Address - Country:US
Practice Address - Phone:253-455-2957
Practice Address - Fax:253-322-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty