Provider Demographics
NPI:1285234815
Name:STUTZNEGGER, ELIZABETH (BCBA)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:
Last Name:STUTZNEGGER
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12009 NE 99TH ST STE 1430
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-2497
Mailing Address - Country:US
Mailing Address - Phone:360-560-8570
Mailing Address - Fax:
Practice Address - Street 1:12009 NE 99TH ST STE 1430
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-2497
Practice Address - Country:US
Practice Address - Phone:360-560-8570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60983542OtherWA HEALTH DEPARTMENT