Provider Demographics
NPI:1215400932
Name:DRASNY, PHILIP (BCBA)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:DRASNY
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25126 62ND AVE S APT KK303
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4972
Mailing Address - Country:US
Mailing Address - Phone:408-529-3809
Mailing Address - Fax:
Practice Address - Street 1:25126 62ND AVE S APT KK303
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4972
Practice Address - Country:US
Practice Address - Phone:408-529-3809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WA1-21-55220103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician