Provider Demographics
NPI:1477025872
Name:MCALLISTER, KAREN (BCBA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 130TH AVE NE STE 202
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1761
Mailing Address - Country:US
Mailing Address - Phone:425-773-6640
Mailing Address - Fax:
Practice Address - Street 1:2310 130TH AVE NE STE 202
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1761
Practice Address - Country:US
Practice Address - Phone:425-773-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-23
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA60765071103K00000X
WACB60769261106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst