Provider Demographics
NPI:1285008094
Name:ROBERTS, CHRISTOPHER JON (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JON
Last Name:ROBERTS
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 1:17600 134TH AVE SE APT D206
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6888
Mailing Address - Country:US
Mailing Address - Phone:425-902-6248
Mailing Address - Fax:
Practice Address - Street 1:14201 SE PETROVITSKY RD
Practice Address - Street 2:SUITE A3-142
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8986
Practice Address - Country:US
Practice Address - Phone:425-902-6248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst