Provider Demographics
NPI:1245988104
Name:WARD, MAGDALENA SUSAN (LABA)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:SUSAN
Last Name:WARD
Suffix:
Gender:
Credentials:LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24120 VAN RY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5459
Mailing Address - Country:US
Mailing Address - Phone:425-412-9019
Mailing Address - Fax:
Practice Address - Street 1:24120 VAN RY BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5459
Practice Address - Country:US
Practice Address - Phone:425-412-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2025-04-16
Deactivation Date:2025-03-03
Deactivation Code:
Reactivation Date:2025-04-16
Provider Licenses
StateLicense IDTaxonomies
WA61276832106E00000X
WARBT-17-46738106S00000X
WAAB61276832106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician