Provider Demographics
NPI:1790114593
Name:ABEC LLC
Entity Type:Organization
Organization Name:ABEC LLC
Other - Org Name:NORTHWEST ABA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAKANORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-313-8840
Mailing Address - Street 1:4516 NE 94TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3933
Mailing Address - Country:US
Mailing Address - Phone:206-226-1472
Mailing Address - Fax:
Practice Address - Street 1:2319 N 45TH ST STE 313
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6979
Practice Address - Country:US
Practice Address - Phone:206-313-8840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
027251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health