Provider Demographics
NPI:1154913812
Name:COLLABORATIVE BEHAVIORAL APPROACH
Entity type:Organization
Organization Name:COLLABORATIVE BEHAVIORAL APPROACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, MHP
Authorized Official - Phone:253-355-7428
Mailing Address - Street 1:PO BOX 866
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-0866
Mailing Address - Country:US
Mailing Address - Phone:253-355-7428
Mailing Address - Fax:360-832-1687
Practice Address - Street 1:502 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-5001
Practice Address - Country:US
Practice Address - Phone:253-355-7428
Practice Address - Fax:360-832-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health