Provider Demographics
NPI:1316241185
Name:WEST COAST BEHAVIORAL CONSULTANTS, INC.
Entity type:Organization
Organization Name:WEST COAST BEHAVIORAL CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS BCBA
Authorized Official - Phone:206-905-4660
Mailing Address - Street 1:24 ROY ST # 434
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4018
Mailing Address - Country:US
Mailing Address - Phone:206-905-4660
Mailing Address - Fax:
Practice Address - Street 1:5624 7TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-2729
Practice Address - Country:US
Practice Address - Phone:206-384-4142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services