Provider Demographics
NPI:1134510985
Name:AWANA, TARYN KEOLA OKALANI (MED, BCBA, AAC)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:KEOLA OKALANI
Last Name:AWANA
Suffix:
Gender:F
Credentials:MED, BCBA, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2947 216TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8011
Mailing Address - Country:US
Mailing Address - Phone:808-979-1824
Mailing Address - Fax:
Practice Address - Street 1:2947 216TH ST SW
Practice Address - Street 2:
Practice Address - City:BRIER
Practice Address - State:WA
Practice Address - Zip Code:98036-8011
Practice Address - Country:US
Practice Address - Phone:808-979-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-14-17089103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst