Basic Information
Provider Information
NPI: 1740608553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BADGETT
FirstName: NATALIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6401 65TH AVE NE APT 4902
Address2:  
City: SEATTLE
State: WA
PostalCode: 981158732
CountryCode: US
TelephoneNumber: 8184481585
FaxNumber:  
Practice Location
Address1: 13010 NE 20TH ST STE 300
Address2:  
City: BELLEVUE
State: WA
PostalCode: 980052054
CountryCode: US
TelephoneNumber: 4256446328
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/31/2014
LastUpdateDate: 03/31/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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