Provider Demographics
NPI:1104168301
Name:BASSETT, ERIN HASBROUCK (M ED, BCBA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:HASBROUCK
Last Name:BASSETT
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13010 NE 20TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2034
Mailing Address - Country:US
Mailing Address - Phone:425-644-6328
Mailing Address - Fax:
Practice Address - Street 1:4909 25TH AVE NE STE 120
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4107
Practice Address - Country:US
Practice Address - Phone:206-987-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-13-13090103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACL60171241OtherAGENCY AFFILIATED COUNSELOR
WANO NUMBEROtherLEAD BEHAVIOR ANALYST THERAPIST CREDENTIAL, DEPARTMENT OF HEALTH