Provider Demographics
NPI:1104545656
Name:BULTEZ, ARYN
Entity type:Individual
Prefix:
First Name:ARYN
Middle Name:
Last Name:BULTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19117 OLYMPIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-2559
Mailing Address - Country:US
Mailing Address - Phone:206-498-0301
Mailing Address - Fax:
Practice Address - Street 1:4380 S SYRACUSE ST STE 520
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2625
Practice Address - Country:US
Practice Address - Phone:720-282-3372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician