Provider Demographics
NPI:1487083077
Name:WELKER, TROY STEVEN (BCBA)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:STEVEN
Last Name:WELKER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 119TH DR SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-7716
Mailing Address - Country:US
Mailing Address - Phone:206-465-2373
Mailing Address - Fax:425-650-6916
Practice Address - Street 1:15600 REDMOND WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:425-242-0973
Practice Address - Fax:425-650-6916
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-13-14257103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst