Provider Demographics
NPI:1417484866
Name:SPIKES, VIRGINIA (BEHAVIOR ANALYST)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:SPIKES
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21800 SE WAX RD APT P102
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5502
Mailing Address - Country:US
Mailing Address - Phone:206-504-9819
Mailing Address - Fax:
Practice Address - Street 1:4746 11TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4657
Practice Address - Country:US
Practice Address - Phone:206-535-8876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst