Provider Demographics
NPI:1144086067
Name:OUTCOME BEHAVIORAL SOLUTIONS PLLC
Entity type:Organization
Organization Name:OUTCOME BEHAVIORAL SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SUVRATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTOR JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:142-560-6767
Mailing Address - Street 1:15705 36TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4745
Mailing Address - Country:US
Mailing Address - Phone:142-560-6767
Mailing Address - Fax:
Practice Address - Street 1:15705 36TH AVE SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-4745
Practice Address - Country:US
Practice Address - Phone:142-560-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty