Provider Demographics
NPI:1104220987
Name:FLANSBAUM, STEPHEN PATRICK (CNA, NASAM)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PATRICK
Last Name:FLANSBAUM
Suffix:
Gender:M
Credentials:CNA, NASAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12918 NE 122ND LANE APT K405
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-8096
Mailing Address - Country:US
Mailing Address - Phone:928-583-2176
Mailing Address - Fax:
Practice Address - Street 1:12918 NE 122ND LANE APT K405
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-8096
Practice Address - Country:US
Practice Address - Phone:928-583-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst