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Contact Information

BLUE WATER BEHAVIORAL CONSULTING LLC
851 SE PIONEER WAY
201
OAK HARBOR, WA98277
 Phone: 360-333-5684
 Fax: 360-230-3272
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Behavior Analyst

103K00000X
Indicates primary specialty

NPI Profile & details for BLUE WATER BEHAVIORAL CONSULTING LLC

NPI Number 1811311517
LBN Legal business name BLUE WATER BEHAVIORAL CONSULTING LLC
Authorized official RACHEL WAGNER - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/16/2014
Last updated 07/30/2020 - About 6 years ago
Identifiers
License # 1-10-7191
WA Medicaid 2041449
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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