Provider Demographics
NPI:1831490788
Name:FELDMAN, EILEEN KLEIN (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:KLEIN
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHDD COLUMBIA RD
Mailing Address - Street 2:BOX 357920 ROOM 205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7920
Mailing Address - Country:US
Mailing Address - Phone:857-939-0992
Mailing Address - Fax:
Practice Address - Street 1:CHDD COLUMBIA RD
Practice Address - Street 2:BOX 357920 ROOM 205
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7920
Practice Address - Country:US
Practice Address - Phone:206-685-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-07-3421103K00000X
WAPY 60260580103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst