Provider Demographics
NPI:1194694570
Name:NEALON, DAVID MICHAEL
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:NEALON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27121 174TH PL SE STE 105
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4939
Mailing Address - Country:US
Mailing Address - Phone:480-440-0686
Mailing Address - Fax:
Practice Address - Street 1:27121 174TH PL SE STE 105
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4939
Practice Address - Country:US
Practice Address - Phone:480-440-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB70054798106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician