Provider Demographics
NPI:1902554595
Name:MELKONYAN, KARINE (CBT)
Entity Type:Individual
Prefix:
First Name:KARINE
Middle Name:
Last Name:MELKONYAN
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18151 68TH AVE NE APT 303
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-2834
Mailing Address - Country:US
Mailing Address - Phone:818-561-1826
Mailing Address - Fax:
Practice Address - Street 1:18151 68TH AVE NE APT 303
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-2834
Practice Address - Country:US
Practice Address - Phone:818-561-1826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician