Provider Demographics
NPI:1821302456
Name:VEVERKA, YEVGENIYA JANE (BCBA)
Entity Type:Individual
Prefix:
First Name:YEVGENIYA
Middle Name:JANE
Last Name:VEVERKA
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 1:8207 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4229
Mailing Address - Country:US
Mailing Address - Phone:425-765-7004
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:#230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:425-765-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-11-9519103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst