Basic Information
| Provider Information | |||||||||
| NPI: | 1104168301 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BASSETT | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | HASBROUCK | ||||||||
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| Credential: | M. ED., BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13010 NE 20TH ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980052034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256446328 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4909 25TH AVE NE STE 120 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981054107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069878080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2013 | ||||||||
| LastUpdateDate: | 05/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-13-13090 | WA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | CL60171241 | 01 | WA | AGENCY AFFILIATED COUNSELOR | OTHER | NO NUMBER | 01 | WA | LEAD BEHAVIOR ANALYST THERAPIST CREDENTIAL, DEPARTMENT OF HEALTH | OTHER |