Provider Demographics
NPI:1730827106
Name:SCHETSELAAR, ELIZABETH HAVEN (RBT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HAVEN
Last Name:SCHETSELAAR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:HAVEN
Other - Last Name:ROMERO-BISSONNETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8811 S TACOMA WAY STE 204&206
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4595
Mailing Address - Country:US
Mailing Address - Phone:425-217-1140
Mailing Address - Fax:
Practice Address - Street 1:8811 S TACOMA WAY STE 204&206
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4595
Practice Address - Country:US
Practice Address - Phone:425-217-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-22-215786106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician