Provider Demographics
NPI:1013609551
Name:BRODY, SETH (LBA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:BRODY
Suffix:
Gender:M
Credentials:LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:318 E ROWAN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1200
Mailing Address - Country:US
Mailing Address - Phone:509-844-2429
Mailing Address - Fax:509-319-2338
Practice Address - Street 1:5301 TIETON DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3479
Practice Address - Country:US
Practice Address - Phone:509-965-7100
Practice Address - Fax:509-966-9750
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WABA61467562103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst